Hirdes, A; Kantorski, L P
The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.
Yvonne van der Zalm; Willem Nugteren; Thóra Hafsteinsdóttir; Cokky van der Venne; Nienke Kool; prof Berno van Meijel
PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to
Boomsma, J; Dingemans, C A; Dassen, T W
Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.
O'Donovan, Aine; Gijbels, Harry
Self-harm in the absence of suicidal intent is an underexplored area in psychiatric nursing research. This article reports on findings of a study undertaken in two acute psychiatric admission units in Ireland. The purpose of this study was to gain an understanding of the practices of psychiatric nurses in relation to people who self-harm but who are not considered suicidal. Semistructured interviews were held with eight psychiatric nurses. Content analysis revealed several themes, some of which will be presented and discussed in this article, namely, the participants' understanding of self-harm, their approach to care, and factors in the acute psychiatric admission setting, which impacted on their care. Recommendations for further research are offered.
Psychiatric nurses are expert care providers for individuals with mental health needs. The art of caring spans across multiple species, is important to understand, and is universal whether intentions are toward individuals or animals. Pets are often cared for and viewed as family members. The current research examined psychiatric nurses' views on the similarities and differences of caring for patients and their pet dogs. Twenty-five nurses were interviewed. Similarities of caring for patients and canines included trusting relationships, companionship, daily basic needs, and improved communication through monitored body language. Differences in caring included personal expectations, unconditional love, and professional boundaries. Understanding the concepts of caring for patients and pet dogs will provide the opportunity for insight into familial versus professional relationships, improve communication with others, and strengthen the human-animal bond. [Journal of Psychosocial Nursing and Mental Health Services, 55(3), 46-52.]. Copyright 2017, SLACK Incorporated.
Sakauye, Kenneth M.; Camp, Cameron J.
Consultation-liaison psychiatry program in teaching nursing home helped implement six guiding principles, including make patient human to the staff; assume no behavior is random; look for depression or psychosis as source of problems; reduce medications and medication doses; create more homelike environment; and use conditions in which learning…
van der Zalm, Y.C.; Nugteren, W.A.; Hafsteinsdottir, T.B.; van der Venne, C.G.J.M.; Kool, N.; van Meijel, B.
Purpose: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. Conclusions: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask
Gournay, K; Brooking, J
Community psychiatric nurses (CPNs) in the United Kingdom are increasingly working in primary health care settings with less serious mental health problems. This paper describes an economic evaluation of their work using a randomized controlled trial in which 231 patients were assigned to continuing general practitioner care or one of two conditions of CPN intervention. This is only the third systematic economic analysis of community mental health nursing in the UK and the first carried out by mental health nurses. Various costs to patients, their families and the health care system were determined. Results showed that patients receiving CPN intervention experienced less absence from work and that this resulted in a net benefit. However, the cost per quality adjusted life year for intervening with this group of patients was probably several times more than for intervening with the seriously mentally ill. Therefore, if one considers both the clinical and economic results of the study, taken together with the recent results of the review of mental health nursing, there seems little justification for CPNs continuing to work in this area.
Michaël Bilson is a nurse at the psychiatric hospital of Bingerville, in Ivory Coast. Here, he describes his mission supporting the National Health Worker Training Institute. It is the only nurse training school in Ivory Coast. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Adams, Susie M; Black, Patricia
The purpose of this article is to publicize an important new Web-based educational program. Recognizing the growing gap in psychiatric-mental health knowledge and the need to better prepare new graduates and nurses transitioning from other service lines into psychiatric inpatient nursing settings, the American Psychiatric Nurses Association developed a 15-hour, modularized curriculum to provide foundational psychiatric-mental health knowledge. This modularized curriculum, called American Psychiatric Nurses Association Transitions in Practice (ATP) focuses on the knowledge and skills to insure the success of nurses new to psychiatric-mental health nursing settings and to improve the overall care for persons with mental health and substance use disorders. The ATP program is also proving to be useful content for nurses in emergency departments, hospitals, and other health settings to improve their care of patients with psychiatric and mental health needs. A summary of the program modules and a toolkit with suggested measures for nurses, patients, and agency outcomes is described. Feedback from participants completing the ATP program within the first 6 months is overwhelmingly positive and holds promise for widespread application across a variety of health care settings.
Slemon, Allie; Jenkins, Emily; Bungay, Vicky
The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.
Gustafsson, Niclas; Salzmann-Erikson, Martin
Nurses who exert coercive measures on patients within psychiatric care are emotionally affected. However, research on their working conditions and environment is limited. The purpose of the current study was to describe nurses' experiences and thoughts concerning the exertion of coercive measures in forensic psychiatric care. The investigation was a qualitative interview study using unstructured interviews; data were analyzed with inductive content analysis. Results described participants' thoughts and experiences of coercive measures from four main categories: (a) acting against the patients' will, (b) reasoning about ethical justifications, (c) feelings of compassion, and (d) the need for debriefing. The current study illuminates the working conditions of nurses who exert coercive measures in clinical practice with patients who have a long-term relationship with severe symptomatology. The findings are important to further discuss how nurses and leaders can promote a healthier working environment. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 37-43.]. Copyright 2016, SLACK Incorporated.
Full Text Available Background: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people. Objective: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution. Design and method: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process. Results: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met. Conclusion: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person. Keywords: experiences, student nurses, caring, intellectually disabled people, public psychiatric institution
Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S
Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.
Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet
Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…
Rask, Mikael; Brunt, David
Patients and nurses in a Swedish forensic psychiatric unit filled in a questionnaire Verbal and Social Interactions designed to survey patients' and nurses' views on the frequency and importance of nursing interactions in forensic psychiatric care. The patients perceived the 'supportive/encouraging interactions' and the 'reality orientation interactions' as the most frequent interactions and the 'supportive/encouraging interactions' and the 'social skills training' as the most important interactions. The nurses perceived the 'supportive/encouraging interactions' and the 'practical skills training' as the most frequent and the 'supportive/encouraging interactions', 'interpretative interactions' and the 'practical skills training' as the most important interactions. There were significant differences between patients' and nurses' perceptions about the frequency of all the different groups of interactions, but greater agreement as to the importance. In general, the patients perceived that the interactions occurred less frequently than the nurses. The differences between patients' and nurses' perceptions on the interactions as well as the clinical implications of these differences are discussed.
Feng, Danjun; Li, Hongyao; Meng, Lu; Zhong, Gengkun
The recovery of people with psychiatric disabilities requires high-quality nursing care. However, the existing research on the nursing competencies needed for caring for people with psychiatric disabilities have been based on a narrow competency framework. By adopting a broader competency framework, this study aimed to find the competencies needed for the nursing care of people with psychiatric disabilities in a hospital environment. Accordingly, a questionnaire will be developed to measure these competences. First, a literature review and interviews with psychiatrists, psychiatric nurses, and people with psychiatric disabilities were conducted to develop the pool of competency items. Second, a pilot study was conducted to review the initial pool of items. Finally, a survey of 581 psychiatric nurses was used to conduct a series of principal component analyses to explore the structure of the questionnaire. The 17-item questionnaire included 5 factors, which accounted for 68.60% of the total variance: sense of responsibility, vocational identification, agreeableness, cooperation capacity, and carefulness; the Cronbach's alpha coefficients were 0.85, 0.85, 0.74, 0.80, and 0.77, respectively. Most of the competencies belonged to attitudes, values, and traits, which were overlooked in previous studies. The questionnaire has satisfactory internal reliability and structural validity, and could contribute some to the selection of the psychiatric workforce.
E-Morris, Marlene; Caldwell, Barbara; Mencher, Kathleen J; Grogan, Kimberly; Judge-Gorny, Margaret; Patterson, Zelda; Christopher, Terrian; Smith, Russell C; McQuaide, Teresa
The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care delivery model in a state psychiatric hospital. The quality improvement project team instituted a new model to promote the hospital's vision of wellness and recovery through utilization of the therapeutic relationship and greater clinical accountability. Implementation of the model was accomplished in 2 phases: first, the establishment of a structure to lay the groundwork for accountability and, second, the development of a mechanism to provide a clinical supervision process for staff in their work with clients. Effectiveness of the model was assessed by surveys conducted at baseline and after implementation. Results indicated improvement in clinical practices and client living environment. As a secondary outcome, these improvements appeared to be associated with increased safety on the units evidenced by reduction in incidents of seclusion and restraint. Restructuring of the service delivery system of care so that clients are the center of clinical focus improves safety and can enhance the staff's attention to work with clients on their recovery. The role of the advanced practice nurse can influence the recovery of clients in state psychiatric hospitals. Future research should consider the impact on clients and their perceptions of the new service models.
Ward, M; Cowman, S
In recent years, mental health services across Europe have undergone major organizational change with a move from institutional to community care. In such a context, the impact of change on the job satisfaction of psychiatric nurses has received little attention in the literature. This paper reports on the job satisfaction of psychiatric nurses and data were collected in 2003. The population of qualified psychiatric nurses (n = 800) working in a defined geographical health board area was surveyed. Methodological triangulation with a between-methods approach was used in the study. Data were collected on job satisfaction using a questionnaire adopted from the Occupational Stress Indicator. A response rate of 346 (43%) was obtained. Focus groups were used to collect qualitative data. Factors influencing levels of job satisfaction predominantly related to the nurses work location. Other factors influencing job satisfaction included choice of work location, work routine, off duty/staff allocation arrangements, teamwork and working environment. The results of the study highlight to employers of psychiatric nurses the importance of work location, including the value of facilitating staff with choices in their working environment, which may influence the recruitment and retention of nurses in mental health services.
Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke
To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.
Capri, Charlotte; Buckle, Chanellé
Background: Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.…
Tuvesson, Hanna; Wann-Hansson, Christine; Eklund, Mona
The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.
Full Text Available Abstract Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.
Kumpula, Esa; Ekstrand, Per
Forensic psychiatric care is largely populated by men--as patients, caregivers, and nurses. Previous research has not focused on the meaning of gender in this context. The aim of this study is to analyse male nurses' experiences of working with male caregivers and attending to male patients in forensic psychiatric care. Data were collected through interviews with six male nurses. The results consist of five themes. Protection and defence are key aspects of care and male caregivers gain status and authority through their physical strength. This could hamper caring and provide male caregivers with a superior position in the department.
Kelly da Silva Rocha Estrela
Full Text Available This qualitative study aimed to analyze the clinical criteria used for the administration of prescribed medications for use when needed (SOS; and discuss the implication of the findings in this research to clinical psychiatric nursing. The records of female patients admitted to a psychiatric institution in the city of Rio de Janeiro, in the time frame from May to June 2009, were analyzed. In the 38 patient records, 16 prescriptions for medications SOS were found. The mean age of patients was around 45-55 years with a clinical diagnosis of Bipolar Mood Disorder. The medication category most prescribed as SOS was of benzodiazepines, followed by antipsychotics. It was noticed a tendency to not valuing the administration of medication in SOS notes. The study points out the importance to establish clinical criteria to indicate the need, or not, to administer prescribed SOS medications.
Full Text Available The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.
Tseng, Kuan-Jui; Liou, Tsan-Hon; Chiu, Hung-Wen
A lot of researches have proven that health education can help patients to maintain and improve their health. And it also shortens the time staying in hospital to save medication resource. Because the patients are willing to get healthcare knowledge to enhance the ability of self-care, they pay more attention to the health education. In Taiwan, the clinical nurses play an important role in patient education, and the health education take most time in their daily work. Such work includes the collection, production and delivery of education materials. To generate the correct and customized health education material is the key of success of patient education. In this study, we established a computer-aided health education contents generating system for psychiatric patients by integrating the databases for disease, medicine and nursing knowledge to assist nurse generating the customized health education document suitable for different patients. This system was evaluated by clinical nurses in usability and feasibility. This system is helpful for nurse to carry out the clinical health education to patients and further to encourage patient to pay attention to self-health.
Ellis, Horace; Alexander, Vinette
There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in
Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. The study design was descriptive and cross-sectional. RESEARCH CONTEXT: Methods comprised of a questionnaire administered to psychiatric nurses (n=202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience. PARTICIPANTS consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n=202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study. The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence. The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor. In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a
Shiau, Shu-Jen; Lee, Shu-Hong
Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process.
Kurjenluoma, K; Rantanen, A; McCormack, B; Slater, P; Hahtela, N; Suominen, T
This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment. Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed. Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture. Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred. © 2017 Nordic College of Caring Science.
The architectural design of psychiatric care buildings. In addition to certain "classic" creations, the Dunet architectural office has designed several units for difficult patients as well as a specially adapted hospitalisation unit. These creations which are demanding in terms of the organisation of care require close consultation with the nursing teams. Testimony of an architect who is particularly engaged in the universe of psychiatry.
Al-Majid, Sadeeka; Al-Majed, Hashmiya; Rakovski, Cyril S; Otten, Rebecca A
Although many psychiatric hospital nurses in Bahrain attend at least one continuing nursing education (CNE) activity per year, many others do not. This study explored these nurses' perceptions of CNE and factors that promote or hinder participation in CNE activities. A descriptive design was used to gather data from a convenience sample of 200 nurses working at the psychiatric hospital in Bahrain. Nurses believed that CNE improved the quality of patient care and patient outcomes, increased nurses' knowledge and skills, and kept them current with advances in nursing. Participation in CNE was hindered by unavailability of CNE activities related to psychiatric nursing. The majority of nurses had positive perceptions of CNE. Their participation was hindered by unavailability of CNE activities related to psychiatric nursing. Those responsible for planning continuing education in Bahrain should consider these findings when planning future CNE activities. Copyright 2012, SLACK Incorporated.
Hein, Laura C; Scharer, Kathleen M
This paper discusses the progression of developments in psychiatric-mental health nursing from the 1960s to the present. The 1960s were a time of shortage of psychiatric APRNs, with legislation expanding the availability of mental health services. We find ourselves in a similar time with 7 million new health insurance enrollees, because of the Affordable Care Act (ACA). The expansion of health insurance coverage comes at a time when some colleges of nursing are closing master's programs in psychiatric-mental health, in lieu of the DNP mandate from the American Association of Colleges of Nursing. Is history repeating itself? Copyright © 2014 Elsevier Inc. All rights reserved.
Mason, T; Coyle, D; Lovell, A
This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty; (2) the skills best suited to overcome those problems; and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top ten' list of main problems with possible solutions and main areas for development. The conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.
Kim, Min-Shik; Patterson, Kathleen T
The purpose of this study was to test the assumption that caring could be taught by nurse educators in the classroom environment and that learning to be self-aware in a mindful state would facilitate students to listen more closely to their inner spirit, which would affect caring behaviors. A convenience sample of 238 students in the Psychiatric-Mental Health Nursing course in a baccalaureate program was obtained from 2007 to 2011. At the beginning of each class and throughout the semester, self-awareness was explained to the students, a reflection statement was read, and students were asked to take two minutes of quiet time, with their eyes closed. At the end of each semester, an author-composed Self-Awareness Questionnaire and Measurement Scale was administered to consenting students to assess whether self-awareness led to caring behaviors. Students' responses were analyzed using descriptive statistics. Findings were positive and supported the assumption that self-awareness and silence positively affected caring behaviors in nursing students in their psychiatric nursing rotation.
TOPIC/PROBLEM: Since 1978, the federal inmates of Canada serving time have had access to a full range of psychiatric care within the carceral system. Five psychiatric units are part of the Federal Correctional Services. Nursing practice in forensic psychiatry opens up new horizons in nursing. This complex professional nursing practice involves the coupling of two contradictory socio-professional mandates: to punish and to provide care. The purpose of this article is to present the results of a grounded theory doctoral study realized in a multi-level security psychiatric ward of the Canadian Federal Penitentiary System. The theoretical work of the late French philosopher, Michel Foucault, and those of sociologist, Erving Goffman, are used to illuminate the qualitative data that emerged from the author's fieldwork. A Foucauldian perspective allows us to understand the way forensic psychiatric nursing is involved in the governance of mentally ill criminals through a vast array of power techniques (sovereign, disciplinary, and pastoral) which posited nurses as "subjects of power". These nurses are also "objects of power" in that nursing practice is constrained by formal and informal regulations of the penitentiary context. As an object of "governmental technologies", the nursing staff becomes the body onto which a process of conforming to the customs of the correctional milieu is dictated and inscribed. The results of this qualitative research, from a nursing perspective, are the first of their kind to be reported in Canada since the creation of the Regional Psychiatric Correctional Units in 1978.
Looff, P.C. de; Kuijpers, E.; Nijman, H.L.I.
During a total of 30 shifts, the arousal levels of 10 psychiatric nurses were assessed while working on a (forensic) psychiatric admissions ward. Arousal was assessed by means of a small device (wristband) by which the Skin Conductance Level (SCL) of the participating nurses was monitored. Each
Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa
A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.
Hardy, Lyons T
Encopresis is an elimination disorder that involves symptoms of fecal incontinence in children. It affects an estimated 1.5% to 7.5% of children ages 6 to 12 and accounts for approximately 3% to 6% of psychiatric referrals. The etiology of encopresis is thought to be related to physiologic problems such as constipation; however, it is also a psychiatric diagnosis and anecdotally may have some association with psychiatric problems. Publications on this association and publications directed toward psychiatric nurses are limited. Encopresis is typically treated with nutritional and medical management along with behavioral modification. Psychiatric nurses working with patients who have encopresis in inpatient settings will have unique concerns and challenges. This article gives an overview of published literature from the past 10 years on the etiology and treatment of encopresis. Specific suggestions for inpatient psychiatric nurses based on published literature and the author's professional experience are provided.
Zahourek, R; Tower, M
It is noted that as abortion becomes an accepted medical practice, more nurses will be involved in the treatment and counseling of the therapeutic abortion patient. The authors, psychiatric nurses in a Colorado comprehensive urban mental health center, became involved in the treatment of the therapeutic abortion patient with the passing of the State's liberalized 1967 abortion law. As they became involved with all aspects of therapeutic abortion patients' care, they identified 3 specific roles for the psychiatric nurse: 1) providing direct They treatment, 2) providing liaison service and promoting continuity of care for the patient, and 3) providing consultation service to the staff involved with the patient. As the psychiatric nurses shared their own mixed feelings about abortion with the obstetrical staff, the staff began to feel less guilty and less alone with their feelings. The became more involved with the patients and benefited them more.
Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane
This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duratio...
Carpenter, Lindsey M; Hubbard, Grace B
The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.
Bostrom, Andrea C
Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence.
Chen, Wen-Ching; Sun, Yu-Hua; Lan, Tsuo-Hung; Chiu, Hsien-Jane
This one-year follow-up study determined the incidence and risk factors of workplace violence against nursing staff in a psychiatric hospital. The cohort members had a website to report events whenever they came across violence. A total of 971 events were reported. The incidence rates of physical violence, verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 1.7, 3.7, 0.2, 0.3, and 0 per staff-year, respectively. Young age, female sex, lower education, shorter duration of employment, and high level of anxiety of staff seemed to be the determinants of violence. Pre-placement education should focus on these staff to reduce workplace violence.
Feely, M; Long, A
This paper presents a theory of connectivity, which was formulated from the findings of a Classical Grounded Theory study that was designed to capture a sample of people's perceptions of living with depression or caring for individuals with depression. Data were collected from: (1) a focus group consisting of people with depression (n = 7), of which five were patients in the community and two were nurses; (2) one-to-one interviews with patients in the community (n = 5) and nurses (n = 5), three of whom had experienced depression from both sides of the caring process; and (3) two 'happy accident' focus groups (n = 25; n = 18) comprising of healthcare workers with a shared understanding of depression. Purposeful sampling was used initially. Thereafter, in keeping with one of the key tenets of grounded theory, theoretical sampling was used until theoretical saturation occurred. Data were analysed using the constant comparative approach together with the NVivo qualitative analysis software package. The core category that emerged was 'connectivity' relating to the connections and disconnections, which people make in their lives. Six key categories emerged all of which were integrated with the core category. Hence, connectivity provided a significant platform for understanding and responding to the life experience of depression. They were: (1) life encounters on the journey to naming; (2) depression: What's in a name? The silent thief; (3) tentative steps to health care; (4) connective encounters and challenges; (5) connecting with self; and (6) self-connection maintenance. Subsequently, a theory, 'Depression: a psychiatric nursing theory of connectivity', surfaced from the overall findings. We argue that this theory of connectivity provides a framework that people working in the field of holistic treatment and care could use to better understand and respond to the life experience of people living with depression.
Dias, Maraína Gomes Pires Fernandes; de Vargas, Divane
This study examines nurses' attitudes towards violent behaviour and the management of aggressiveness. A convenience sample of 185 nurses working in psychiatric urgent care and emergency services in Brazil responded to the MAVAS-BR. The results show that nurses' attitudes are more reflective of the external and situational models of violent behaviour and the use of control methods to manage aggressiveness. The mapping of this phenomenon using the same tools in a different context from those traditionally studied while observing similar results suggests a pattern of attitudes towards violent behaviour and the management of aggressiveness among nurses around the world.
Yada, Hironori; Abe, Hiroshi; Omori, Hisamitsu; Matsuo, Hisae; Masaki, Otsubo; Ishida, Yasushi; Katoh, Takahiko
In psychiatric nursing, female nurses tend to spend more time building rapport with patients and developing cooperative working relationships with colleagues; they encounter more sexual harassment by patients. In contrast, male nurses respond to aggressive patients and tend to resist physically caring for female patients; they encounter more physical and verbal assault from patients. These gender differences might result in differences in job-related stress. We quantitatively examined gender differences in psychiatric nurses' job stress. The Psychiatric Nurse Job Stressor Scale and the Stress Reaction Scale of the Brief Job Stress Questionnaire were administered to 159 female and 85 male Japanese psychiatric nurses. The results indicated that female nurses had significantly higher stress levels than males related to psychiatric nursing ability, attitude towards nursing, and stress reactions of fatigue and anxiety. Moreover, the factors affecting stress reactions differed somewhat between sexes. In particular, male nurses reported that greater irritability was affected by patients' attitudes. Their anxiety and somatic symptoms were affected by their attitude towards nursing, and depressed mood was affected by psychiatric nursing ability. Knowledge of these differences can lead to better mental health-care interventions for psychiatric nurses. © 2014 Australian College of Mental Health Nurses Inc.
Zahourek, Rothlyn P
In this era of high-tech care, many Americans seek more holistic approaches and alternative and complementary treatments for health problems, including mental illness. Psychiatric-mental health (PMH) nurses need to be aware of these approaches as they assess clients, maintain a holistic approach, and in some cases, provide skilled, specific modalities. This article reviews holistic philosophy and integrative approaches relevant to PMH nurses. The emphasis is that whichever modality PMH nurses practice, a holistic framework is essential for providing optimal PMH care.
Alexander, Robbi K; Diefenbeck, Cynthia A; Brown, Carlton G
The demand for mental health services in the United States taxes the existing care continuum and is projected to increase as federal initiatives such as the Affordable Care Act and mental health parity improve access to, and coverage for, mental health services. Quality health care providers, such as psychiatric-mental health nurses, are needed to bolster the mental health system. Prior research has focused on the unpopularity of psychiatric nursing as a career choice for nursing students. The purpose of this study is to understand how seasoned psychiatric nurses came to choose and remain in the specialty; descriptive phenomenology is used. In a face-to-face interview, eight registered nurses described their experiences with psychiatric nursing as a student, their entry into psychiatric nursing, and factors related to their longevity in the specialty. Giorgi's Existential Phenomenological Research Method was employed to analyze the interview data. Three themes emerged related to career choice: Interest Developed Prior to or While in Nursing School, Personal Relevance, and Validation of Potential. Three themes emerged related to retention: Overcoming Stereotypes to Develop Career Pride, Positive Team Dynamics, and Remaining Hopeful. Nurse educators play an important role in identifying talent, validating capability, enhancing interest, and increasing students' confidence to pursue a psychiatric nursing career, while nursing administrators and clinical specialists play a key role in retention. Findings also stimulate pertinent questions surrounding the long-term viability of the psychiatric-mental health nursing specialty.
Bimenyimana, E; Poggenpoel, M; Myburgh, C; van Niekerk, V
Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch 's (Creswell, 2004: 256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an "I don't care" attitude.
Full Text Available The demand for psychiatric services in modern health care system will increase due to the growth in number of mental diseases. The role of nurses in prevention, treatment and rehabilitation of mental illness has a number of features. These features are related to care of patients with high level of aggressiveness, behavioral deviations, and problems in self-service. Differences in procedure practice and communicative space specialize and make narrower the nurses' professional practice in psychiatry and determine appearance of specific mechanisms and norms bound up with the necessity of supervision of patients while respecting their rights. Personnel's oversight functions, deviant behavior of patients, high degree of closure of psychiatric medical institutions — are the reasons for specialization of nurses' professional group in psychiatry, forming special mechanisms of maintaining tolerance to patients in professional sphere of this community.
Huang, Hui-Man; Sun, Fan-Ko
Psychiatric nurses have a special obligation and legal duty as guarantor against criminal negligence. The guarantor role and medical negligence in psychiatric nursing are topics that have been neglected in Taiwan. (1) Identify the status of psychiatric nurses as guarantors; (2) Understand the causal relationship in a legal context between this status and Non-Genuine Omission in the current case; (3) Understand the facts and the dispute in the current case. (4) Explore the reasons why the psychiatric nurse was convicted for criminal negligence in the current case. A literature review and case study were used to analyze the high court criminal judgment and sentence reconsideration of the first instance No. 122 (2005). (1) Psychiatric nurses hold two guarantor roles in Taiwan. One role is as legally protected interest guarantor and the other is as supervisors' dangerous source guarantor. (2) The three sources of guarantor status relevant to the current case are: nurses' voluntary commitments; medical contract; duty of care of supervisors. (3) In this case, the psychiatric nurse did not discharge her obligations as guarantor and failed to prevent the patient from committing suicide. Negligence resulted in patient death and the psychiatric nurse was found guilty. In order to prevent criminal acts, psychiatric nurses should gain a better understanding of their status as guarantor and the obligations entailed in this status. This article is intended to assist psychiatric nurses understand their responsibilities under current laws.
Baysan Arabacı, Leyla; Çam, M Olcay
To determine the attitudes nurses working at psychiatric hospitals in Turkey have towards forensic psychiatric patients and the associated factors. This cross-sectional study included 620 nurses working at 8 psychiatric hospitals in Turkey that completed ≥80% of the Nurses' Attitudes Towards Forensic Psychiatric Patients Scale (NAFPPS). Data were evaluated based on number-percentage distribution, and the relationship between variables was examined via t-test, variance analysis, and correlation analysis. Mean age of the nurses was 34.37 ± 7.48 years and 79.4% were female. Mean NAFPPS total and subscale scores were as follows: Xtotal = 69.07 ± 12.46 (max: 125); Xfeelingthreatened = 15.98 ± 3.61 (max: 30); Xtrust = 20.49 ± 5.24 (max: 20); Xsocialdistance = 10.45 ± 3.33 (max: 20); Xwillingnesstoprovidecare = 22.31 ± 4.25 (max: 40). Gender, place of employment, method of obtaining current position, employment status, level of satisfaction working as a psychiatric nurse, history of providing treatment to forensic psychiatric patients, having knowledge of Turkish laws regarding the treatment of forensic psychiatric patients, and thinking that nurses should treat forensic psychiatric patients were correlated with the nurses' attitudes towards forensic psychiatric patients, whereas age, marital status, place of longest residence, level of education, duration of working in the profession, and duration at current hospital were not. Despite the fact that the nurses working at 8 psychiatric hospitals in Turkey considered forensic psychiatric patients threatening, didn't trust them, and had a tendency to be socially distant with them, they had a moderate level of willingness to provide them proper care.
Nijman, H.L.I.; Bowers, L.; Oud, N.E.; Jansen, G.J.
Using a survey instrument, the experiences of psychiatric nurses with inpatienaggression were investigated in East London, U.K. On this Perceptions of Prevalence Of Aggression Scale (POPAS), annual experiences with 15 types of disruptive and aggressive behavior were rated anonymously. Staff members
Nijman, H.; Bowers, L.; Oud, N.; Jansen, G.
Using a survey instrument, the experiences of psychiatric nurses with inpatient aggression were investigated in East London, U.K. On this "Perceptions of Prevalence Of Aggression Scale" (POPAS), annual experiences with 15 types of disruptive and aggressive behavior were rated anonymously. Staff
Full Text Available Abstract Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001. There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001. Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital.
Hasan, Abd Alhadi; Elsayed, Sonia; Tumah, Hussein
Psychiatric nurses experience a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse, and poor prognosis of mental disorders. The aim of the study was to assess workplace stress, coping strategies, and levels of depression among psychiatric nurses. A descriptive correlation design was conducted on psychiatric nurses working in mental health settings Port-Said, Egypt. Data were collected from 70 nurses at a mental health hospital. The results revealed that psychiatric nurses had moderate levels of work-related stress and depression, and exhibiting different coping strategies. Stress and depression are prevalent among psychiatric nurses. Implementing programs aimed at teaching them how to deal with stress at work and improving their coping strategies and problem-solving skills are recommended. © 2018 Wiley Periodicals, Inc.
This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.
The extensive clinical experience of senior nurses is a valuable resource to assist new nurses to prepare for their professional future in the clinical environment. This study employed the professional life narratives of psychiatric nurses in Taiwan to establish professional meaning and create a development image for Taiwan psychiatric nurses. This study used a narrative approach to interview a psychiatric nurse with nearly thirty years of clinical experience. Researchers analyzed findings and constructed a new meaningful vision in light of social and cultural changes. Results identified three periods, namely Enlightenment, Shaping, and Spiritual Care. Enlightenment focuses on the nurse as a helper; Shaping focuses on the fundamental need for nurses; and Transmitting focuses on spiritual care. These periods outline a development image for psychiatric care in which effectiveness of care shifts from "individual" to "professional". The significance of caring for psychiatric patients should be perceived through shaping, which is generated by social interaction. This case study may be applied to enhance psychiatric nursing education.
Koekkoek, B.; van Meijel, B.; Schene, A.; Smit, A.; Kaasenbrood, A.; Hutschemaekers, G.
Background: In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the
B. Koekkoek; G. Hutschemaekers; A. Smit; A. Schene; A. Kaasenbrood; prof Berno van Meijel
In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It
Molin, Jenny; Lindgren, Britt-Marie; Graneheim, Ulla Hällgren; Ringnér, Anders
Despite the long-known significance of the nurse-patient relationship, research in psychiatric inpatient care still reports unfulfilled expectations of, and difficulties in, interactions and relationships between patients and staff. Interventions that create structures to allow quality interactions between patients and staff are needed to solve these problems. The aim of this project is to test effects of the nursing intervention Time Together and to evaluate the intervention process. This is a multisite study with a single-system experimental design using frequent measures. The primary outcomes are quality interactions for patients and perceived stress for staff. Secondary outcomes are levels of symptoms of anxiety and depression for patients and stress of conscience for staff. A process evaluation is performed to describe contextual factors and experiences. Data are collected using questionnaires, participant observations and semistructured interviews. For analysis of quantitative data, both visual and statistical methods will be used. Qualitative data will be analysed using qualitative content analysis. Ethical approval was granted by the Ethical Review Board in the region (Dnr 2016/339-31). The findings will contribute to the development of nursing interventions in general, but more specifically to the development of the intervention. This is relevant both nationally and internationally as similar interventions are needed but sparse. The findings will be disseminated through conference presentations and peer-reviewed publications. NCT02981563. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available Introduction: Evidence suggests that stressful situations are frequent in the field of psychiatry and that professionals working in this speciality are more prone to stress. Stressful situations may be compounded by ignoring the principles and strategies of therapeutic communication in all interactions with patients. The purpose of the research was to determine the presence of stress among the nursing team members. Methods: The research is based on a quantitative methodology; the data were collected using a semi-structured questionnaire. The sample consisted of 73 nurses working in a special social welfare institution (n = 37 and in a psychiatric hospital (n = 36. The survey was conducted in the first half of the year 2016. Descriptive statistics and chi-square test were used. Results: The list of stress factors most frequently reported by the participants include low pay (n = 40, 55 %, poor interpersonal relationships in the workplace (n = 23, 32 %, and the sense of insecurity due to unpredictable behaviour of patients (n = 32, 44 %. One fifth of the respondents are regularly subjected to patient physical violence and psychological abuse in the workplace (n = 14, 19 % and a large majority (n = 53, 72.5 % are frequently exposed to dangerous situations. The respondents are not fully aware of the crucial importance of therapeutic communication with the patients (n = 38, 52 %. Discussion and conclusion: It is impossible to completely avoid stressful situations in psychiatric settings. Psychiatric nurses should possess good communication skills and the ability to develop good interpersonal relationships.
Haglund, K; von Knorring, L; von Essen, L
To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for
Jansen, Trine-Lise; Hanssen, Ingrid
The aim of this study was to explore psychiatric nurses' experiences and perspectives regarding patient participation. Patient participation is an ambiguous, complex and poorly defined concept with practical/clinical, organisational, legal and ethical aspects, some of which in psychiatric units may cause ethical predicaments and moral stress in nurses, for instance when moral caring acts are thwarted by constraints. An explorative quantitative pilot study was conducted at a psychiatric subacute unit through three focus group interviews with a total of nine participants. A thematic analytic approach was chosen. Preliminary empirical findings were discussed with participants before the final data analysis. Ethical research guidelines were followed. Patient participation is a difficult ideal to realise because of vagueness of aim and content. What was regarded as patient participation differed. Some interviewees held that patients may have a say within the framework of restraints while others saw patient participation as superficial. The interviewees describe themselves as patient's spokespersons and contributing to patients participating in their treatment as a great responsibility. They felt squeezed between their ethical values and the 'system'. They found themselves in a negotiator role trying to collaborate with both the doctors and the patients. Privatisation of a political ideal makes nurses vulnerable to burn out and moral distress. Nurses have a particular ethical responsibility towards vulnerable patients, and may themselves be vulnerable when caught in situations where their professional and moral values are threatened. Unclear concepts make for unclear division of responsibility. Patient participation is often a neglected value in current psychiatric treatment philosophy. When healthcare workers' ethical sensibilities are compromised, this may result in moral stress. © 2016 Nordic College of Caring Science.
In Canada, psychiatric nursing care is provided by two kinds of nurses. East of Manitoba, it is provided by registered nurses who may or may not have specialized psychiatric nursing education. In the four western provinces, a distinct professional group, registered psychiatric nurses, also provide care. Saskatchewan was the first province to achieve distinct legislation, in 1948, followed by British Columbia in 1951, Alberta in 1955, and Manitoba in 1960. Several factors coalesced to sway Manitoba to adopt the distinct profession model. First, there was little interest by the general nursing body in mental hospital nursing. Second, the other three western provinces had formed a Canadian Council of Psychiatric Nursing that encouraged mental hospital attendants and nurses in Manitoba. Third, a group of male attendants took on leadership roles supported by the mental hospital superintendents. Finally, Manitoba was culturally and geographically more aligned with western than eastern Canada.
The Rise of Mental Health Nursing onderzoekt de tegenstrijdigheden in de op het ziekenhuis georiënteerde inrichtingszorg, die rond 1900 opkwam. Bovendien illustreert het boek de sociale complexiteit van de psychiatrische zorg. Op basis van archiefmateriaal uit vier Nederlandse psychiatrische
Caffrey, R A; Caffrey, P A
Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.
Full Text Available Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naïve sketches. Tesch’s (Creswell, 2004:256 method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT; and the lack of structured and comprehensive orientation among newly appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an “I don’t care” attitude.
Schenin-King, Palmyre; Thomas, Fanny; Braha-Zeitoun, Sonia; Bouaziz, Noomane; Januel, Dominique
Therapies based on cognitive remediation integrate psychiatric care. Cognitive remediation helps to ease cognitive disorders and enable patients to improve their day-to-day lives. It is essential to complete nurses' training in this field. This article presents the example of a patient with schizophrenia who followed the Cognitive Remediation Therapy programme, enabling him to access mainstream employment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Mendes, Davidson Passos; Moraes, Geraldo Fabiano de Souza; Mendes, Juliana Cristina de Lima
Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.
Mello, Joanna J; Bell, Janice F; Siegel, Elena O; Ward, Deborah H
Despite increasing emergency department (ED) use for psychiatric emergencies, limited evidence exists to clearly identify the competencies necessary of emergency nurses to care for this population. 1. To define the specialized skill and knowledge of emergency nurses by examining the frequency with which recommended psychiatric nursing competencies are performed in the ED setting. 2. To assess emergency nurses' rankings of importance and self-efficacy related to recommended psychiatric nursing competencies in order to explore their relevance to emergency nursing. Emergency nurses (n = 75) completed a survey ranking the frequency, importance and self-efficacy of 15 psychiatric nursing competencies. Data analysis revealed competency relevance and regression analysis demonstrated factors that may contribute to self-efficacy. Nurses reported performing psychiatric competencies frequently (mean scores of 0.64 to 3.04). Importance rankings were highest (mean scores of 1.81 to 3.67). Self-efficacy mean scores ranged from 0.89 to 3.47. Frequency and importance of activities predicted higher self-efficacy scores. Younger age and competencies often, and existing competencies appear applicable. As frequency and importance of competencies influence self-efficacy, practice and interventions to underscore the importance of competencies may improve self-efficacy. Younger and less experienced nurses might require more support. Copyright © 2016 Elsevier Ltd. All rights reserved.
Koekkoek, Bauke; van Baarsen, Carlijn; Steenbeek, Mirella
To determine the effects of multidisciplinary, nurse-led psychiatric consultation on behavioral problems of nursing home residents. Residents often suffer from psychiatric symptoms, while staff psychiatric expertise varies. A pre-post study was conducted in seven homes using the Neuropsychiatric Inventory Nursing Home version (NPI-NH). In 71 consultations during 18 months, 56-75% of residents suffered from agitation/aggression, depression, anxiety, and disinhibition. Post-intervention (n = 54), frequency, and severity of psychiatric symptoms were significantly and clinically meaningfully reduced. Also, staff suffered from less work stress. Nurse-led psychiatric consultation is valuable to both nursing home residents and staff. © 2015 Wiley Periodicals, Inc.
Left alone--Swedish nurses' and mental health workers' experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study.
Kristiansen, Lisbeth; Hellzén, Ove; Asplund, Kenneth
The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.
Lanza, Marilyn Lewis; Zeiss, Robert; Rierdan, Jill
Psychiatric nurses are frequent victims of workplace violence, much of which is perpetrated by patients. In a review of literature on prevalence, perpetrators, and impact of violence on psychiatric nurses, we note that workplace violence is a virtually normative experience for the nurse, rather than a rare occurrence. Verbal violence and sexual harassment, like physical violence, are common experiences; in contrast to physical violence, these are often initiated by co-workers. The emotional impact of violence on psychiatric nurses is studied less often than frequency of exposure; we discuss hypotheses for this paucity of relevant research. Finally, we reflect on the implications of current research, concluding with recommendations for future research on violence against psychiatric nurses. In particular, we elaborate on the role of violence research in the healthcare setting as "sensitive research"--a research process that in itself may have both direct and indirect beneficial effects for the nursing profession.
Zahourek, Rothlyn P
Ericksonian hypnosis conceptual framework. To acquaint psychiatric-mental health nurses with hypnotic principles and how these can be integrated into their practice. Published literature and author's clinical experience. Ericksonian hypnosis offers an array of potential interventions for psychiatric-mental health nurses to integrate into their practices in a framework familiar to nurses: holism, honoring and respecting individuality, and capitalizing on an individual's strengths.
Mason, T; Lovell, A; Coyle, D
This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups: (A) forensic psychiatric nurses; (B) non-forensic psychiatric nurses; and (C) other disciplines. A national survey of forensic psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned, making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses' perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tended to focus on personal qualities both in relation to themselves and the patients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencies of forensic nurse training.
Yada, Hironori; Kobayashi, Mako; Odachi, Ryo; Yamane, Toshie
This study aimed to clarify the factors related to self-efficacy experienced by psychiatric nurses. Analysis of qualitative descriptive data from a free self-description questionnaire administered to 16 psychiatric nurses working in psychiatric hospitals revealed 24 codes across the following 8 categories as factors that increase self-efficacy: A1. possibility of practical use in nursing, A2. nursing judgment, A3. improvement of psychiatric symptoms, A4. the patients presenting a positive attitude, A5. building a relationship of trust with the patients, A6. building a relationship of trust with other nurses, A7. work progressing according to plan and A8. team medical practice. Twenty-five codes across the following 10 categories were identified as factors that decrease self-efficacy: B1. lack of communication, B2. uncertainty in caregiving, B3. recurrence of psychiatric symptoms, B4. feeling overpowered by a patient, B5. sense of being too busy to work adequately, B6. difficulty in bringing about self-improvement, B7. sense of loss regarding one's role as a nurse, B8. lack of physical strength, B9. mechanical performance of nursing and B10. fluctuating view of nursing due to mistakes. These factors require intervention for psychiatric nurses' self-efficacy.
Kanerva, A; Kivinen, T; Lammintakanen, J
Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication
This study aimed to discuss how caring science can contribute and provide a theoretical foundation for the development of caring within forensic psychiatric care. It is not only a challenge but also a great opportunity to use caring science theory within forensic psychiatric care when caring for the patients and supporting their health processes. There is a need for more knowledge about, understanding of, and willingness to care for patients within forensic psychiatric settings in a "true caring" way. In order to achieve this, a caring culture is required, one that supports carers and provides them with opportunities to further develop a caring attitude. © 2014 Wiley Periodicals, Inc.
Wilson, H S
An important step in the development of the American Nurses' Association (ANA) Task Force's Classification of Phenomena of Concern for Psychiatric/Mental Health Nursing is a plan for conducting field trials to determine interrater diagnostic reliability using the classification system. The ANA Task Force identified field testing as stage two in a three-stage process for completion of our work. In this article, we identify methodologic directions that will allow us to answer two important questions. First, what is the interrater reliability of the system of psychiatric nursing diagnoses when applied to clients by psychiatric/mental health nurse clinicians in their practice, and second, how do the clinicians who use this system view its usefulness for planning and evaluating nursing care?
Heydari, Abbas; Meshkinyazd, Ali; Soudmand, Parvaneh
Objective: Nurses are the most important staff in the health care system, thus, their job satisfaction is important in nursing management. The present study aimed at determining the impact of teaching spiritual intelligence on the job satisfaction of psychiatric nurses.Methods: The participants were divided into 2 groups by random allocation. Data were collected in 3 stages of before intervention, 4 weeks, and 8 weeks post intervention using Brayfield & Rother Job Satisfaction Questionnai...
Pekurinen, Virve; Willman, Laura; Virtanen, Marianna; Kivimäki, Mika; Vahtera, Jussi; Välimäki, Maritta
Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses) participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability). Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have worse subjective
The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.
Sørensen, Ann Lykkegaard; Mainz, Jan; Nielsen, Lars Peter
Background : Potential inappropiate prescribing (IP) is associated with higher mortality, morbidity and risk of hospitalization. Potential IP has only been investigated in elderly populations and never in a psychiatric setting or a general population. Registered nurses are the healthprofessionals...
Woestelandt, Laure; Touhami, Fatima; Radjack, Rahmeth; Moro, Marie Rose; Lachal, Jonathan
The various traumatic events experienced by young isolated foreigners can weaken them psychologically and cause psychiatric decompensation. A qualitative study, carried out by the Maison de Solenn and the Avicenne hospital, aimed to provide better understanding of the conditions for initiating psychiatric care with these adolescents. The different results show that this type of care for these young migrants must be cross-cultural and multi-disciplinary. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Trondsen Marianne V
Full Text Available Abstract Background Today the availability of specialists is limited for psychiatric patients in rural areas, especially during psychiatric emergencies. To overcome this challenge, the University Hospital of North Norway has implemented a new decentralised on-call system in psychiatric emergencies, by which psychiatrists are accessible by videoconference 24/7. In September 2011, the new on-call system was established in clinical practice for patients and health staff at three regional psychiatric centres in Northern Norway. Although a wide variety of therapies have been successfully delivered by videoconference, there is limited research on the use of videoconferenced consultations with patients in psychiatric emergencies. The aim of this study is to explore the use of videoconference in psychiatric emergencies based on the implementation of this first Norwegian tele-psychiatric service in emergency care. Methods/design The research project is an exploratory case study of a new videoconference service in operation. By applying in-depth interviews with patients, specialists and local health-care staff, we will identify factors that facilitate and hinder use of videoconferencing in psychiatric emergencies, and explore how videoconferenced consultations matter for patients, professional practice and cooperation between levels in psychiatric care. By using an on-going project as the site of research, the case is especially well-suited for generating reliable and valid empirical data. Discussion Results from the study will be of importance for understanding of how videoconferencing may support proper treatment and high-quality health care services in rural areas for patients in psychiatric emergencies.
Full Text Available Introduction: Several research finding indicate that nursing care professionals are often faced with situations which may lead to anxiety. The aim of the present research was to determine the prevalence and typical signs of anxiety among nursing employees and nursing students in psychiatric settings. Methods: The Burns Anxiety Inventory was used as an assessment tool to measure anxiety. The research sample consisted of 242 participants. The data collected were processed by the descriptive statistics, Leveneʹs test, the ANOVA statistical test, the Welchʹs t-test, and the post hoc analysis. Pearsonʹs correlation coefficient was used to measure the strength of the association between the variables. Results: The results of the current study show that nearly half of the participants experience anxiety, but the differences were noted as regards their anxiety thoughts (p = 0.039. Anxiety feelings are more prevalent in female students (p = 0.046. Habitual smokers (p = 0.030 and casual smokers (p = 0.020 are more likely to develop anxious feelings and physical signs of anxiety. The anxiety signs are also more pronounced in the respondents with self-assessed lower economic status (p = 0.001 and poor self-rated health (p = 0.0001. Discussion and conclusion: The professionals and students in psychiatric nursing often encounter situations conducive to the development of anxiety. Further studies on the current topic are therefore recommended to design adequate educational programmes to timely recognise anxiety symptoms and to implement mutual and self-help measure.
Mullen, Antony; Drinkwater, Vincent; Lewin, Terry J
To implement and evaluate the care zoning model in an eight-bed psychiatric intensive care unit and, specifically, to examine the model's ability to improve the documentation and communication of clinical risk assessment and management. Care zoning guides nurses in assessing clinical risk and planning care within a mental health context. Concerns about the varying quality of clinical risk assessment prompted a trial of the care zoning model in a psychiatric intensive care unit within a regional mental health facility. The care zoning model assigns patients to one of 3 'zones' according to their clinical risk, encouraging nurses to document and implement targeted interventions required to manage those risks. An implementation trial framework was used for this research to refine, implement and evaluate the impact of the model on nurses' clinical practice within the psychiatric intensive care unit, predominantly as a quality improvement initiative. The model was trialled for three months using a pre- and postimplementation staff survey, a pretrial file audit and a weekly file audit. Informal staff feedback was also sought via surveys and regular staff meetings. This trial demonstrated improvement in the quality of mental state documentation, and clinical risk information was identified more accurately. There was limited improvement in the quality of care planning and the documentation of clinical interventions. Nurses' initial concerns over the introduction of the model shifted into overall acceptance and recognition of the benefits. The results of this trial demonstrate that the care zoning model was able to improve the consistency and quality of risk assessment information documented. Care planning and evaluation of associated outcomes showed less improvement. Care zoning remains a highly applicable model for the psychiatric intensive care unit environment and is a useful tool in guiding nurses to carry out routine patient risk assessments. © 2013 John Wiley & Sons
DeSocio, Janiece E
The aims of this paper are to synthesize and report research findings from neuroscience and epigenetics that contribute to an emerging explanatory framework for advanced practice psychiatric nursing. Discoveries in neuroscience and epigenetics reveal synergistic mechanisms that support the integration of psychotherapy, psychopharmacology, and psychoeducation in practice. Advanced practice psychiatric nurses will benefit from an expanded knowledge base in neuroscience and epigenetics that informs and explains the scientific rationale for our integrated practice. © 2015 Wiley Periodicals, Inc.
Hung, B J; Huang, X Y; Cheng, J F; Wei, S J; Lin, M J
Novice psychiatric nurses experience heavy workloads, insufficient training and support in Taiwan. The aim of this study was to understand the working experiences of novice psychiatric nurses during their first year in a clinical setting. A qualitative phenomenological approach, using semi-structured face-to-face interviews was used. Narratives were analyzed using Colaizzi's seven-step method. Data saturation was reached after interviews were conducted with 15 nurses based on the purposive sampling. Four themes and eight sub-themes were identified: struggling (lacking a sense of security and competency), emulating (learning the process of interaction with clients and families, learning an appropriate role from nursing staff), prevailing (developing core competency, creating a therapeutic environment) and belonging (coping with the job, becoming a part of the psychiatric nursing staff). The findings from this study demonstrate that nurses are often inadequately prepared for psychiatric nursing. They have little understanding of mental illness, are unable to communicate appropriately with clients and struggle to cope with the conditions. Our study supports the importance for helping nurses to improve their essential knowledge and skills for coping with the job and providing good quality care, particularly in the first year. © 2014 John Wiley & Sons Ltd.
Simon, Harold; Mykolow, Grégory; Guyodo, Josselin
The management of a suicidal crisis falls within the scope of nursing care. There is a high rate of recurrence in the months following an attempted suicide. The nurse monitoring strategy, based on the principle of the 'recontacting' of patients, has been tested by the team of a post-emergency psychiatric unit of a university hospital. Copyright © 2017. Published by Elsevier Masson SAS.
Full Text Available Aim: The aim of this literature review was to search for qualitative studies focusing on the concept of caring in nursing, to analyse them and to synthesize knowledge that concerns the definition of the concept of caring in nursing from the point of view of nurses and patients. Design: Review. Methods: Qualitative studies were searched for systematically in the electronic databases Academic Search Complete (EBSCO, CINAHL, Medline, Science Direct, and the Wiley Library Online, according to set criteria and defined key words for the period 1970-2015. Seven selected articles were analysed after selection of documents with the aid of a sorting chart. Results: Nurses understand caring in nursing as a relationship with patients which is characterised on the nurses' part by an individual and empathetic approach, attentiveness, experience and sensitivity. Through caring, active communication takes place, providing information which reduces anxiety and leads to the breaking down of barriers. This relationship helps protect patients' autonomy, dignity and comfort. It requires experience on the part of nurses, and it is influenced by the environment. The nurses' personal qualities (what professional knowledge, attitudes and skills they have and their availability, reliability, and emotional and physical support are important to patients. Conclusion: The concept of caring is a content specific interpersonal process which is characterized by the professional knowledge, skills, personal maturity, and interpersonal sensitivity of nurses, which result in the protection, emotional support, and the meeting of bio-psycho-social needs of patients. The results of the overview study could contribute to an explanation and understanding of the nature of caring as a fundamental feature of the discipline of nursing.
Patients with psychiatric problems have the right to receive qualified and humane psychiatric nursing. To meet these requirements nurses should reflect on their daily practice and whether they support clients in respect of autonomy, empowerment and recovery or only meet the requirements of the institution and well-worn routines. The Code of Ethics for Nurses (International Council of Nurses [ICN] and the four principles of Beauchamp and Childress [respect of autonomy, nonmaleficence, beneficence and justice]) help nurses to decide in their daily work on the narrow line between autonomy and treating the patient like a child. Emphasis is laid on the nurses' duty to influence the political development in health services. © Georg Thieme Verlag KG Stuttgart · New York.
McTiernan, K; McDonald, N
Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions
MacNeela, Pádraig; Scott, P Anne; Treacy, Margaret; Hyde, Abbey; O'Mahony, Rebecca
Psychiatric patients are liable to stereotyping by healthcare providers. We explored attitudes toward caring for psychiatric patients among 13 nurses working in general hospitals in Ireland. Participants thought aloud in response to a simulated patient case and described a critical incident of a patient for whom they had cared. Two attitudinal orientations were identified that correspond to stereotypical depictions of risk and vulnerability. The nurses described psychosocial care strategies that were pragmatic rather than authentically person-centered, with particular associations between risk-oriented attitudes and directive nursing care. Nurses had expectations likely to impede relationship building and collaborative care. Implications arising include the need for improved knowledge about psychiatric conditions and for access to professional development in targeted therapeutic communication skills. Copyright © 2012 Wiley Periodicals, Inc.
Cutcliffe, John R; Links, Paul S
It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do.
Psychiatric nursing and psychiatric nurses have been referred to in various ways over the course of history. These articulations reflect and constitute the ways in which nursing is comprehended during specific periods. A rupture in these descriptions and conceptions of Danish psychiatric nursing ...
Full Text Available Psychiatric nurses have played a significant role in disseminating cognitive behavioral therapy (CBT in Western countries; however, in Japan, the application, practice, efficiency, and quality control of CBT in the psychiatric nursing field are unclear. This study conducted a literature review to assess the current status of CBT practice and research in psychiatric nursing in Japan. Three English databases (MEDLINE, CINAHL, and PsycINFO and two Japanese databases (Ichushi-Web and CiNii were searched with predetermined keywords. Fifty-five articles met eligibility criteria: 46 case studies and 9 comparative studies. It was found that CBT took place primarily in inpatient settings and targeted schizophrenia and mood disorders. Although there were only a few comparative studies, each concluded that CBT was effective. However, CBT recipients and outcome measures were diverse, and nurses were not the only CBT practitioners in most reports. Only a few articles included the description of CBT training and supervision. This literature review clarified the current status of CBT in psychiatric nursing in Japan and identified important implications for future practice and research: performing CBT in a variety of settings and for a wide range of psychiatric disorders, conducting randomized controlled trials, and establishing pre- and postqualification training system.
Monique da Silva Carvalho
Full Text Available The aim of this study was to describe the teaching of psychiatric nursing at Ana Néri Nursing School (EAN, between 1925 and 1954. Methodology: Socio-historical research whose sources were written documents and the oral statement of an ex-professor. The documentary analysis technique was used for data treatment. Results: For 27 years, the EAN did not introduce students into the psychiatric field due to the mental illness stigma, offering only theoretical disciplines, which were taught by physicians. Later there were theoretical disciplines with practical training in the classroom, and then theoretical disciplines with practice in psychiatric hospitals, taught by nurses. In conclusion, the law 775/49 lead the EAN to qualify a professor and initiate the reformulation of the nursing care provided at the Institute of Psychiatry of the University of Brazil, so as to adjust it to serve as a practical field and a model for teaching psychiatric nursing in Brazil.
Yadav, B L
Evidence-based practice (EBP) is an approach to health care in which health professionals use the best evidence available to guide their clinical decisions and practice. Evidence is drawn from a range of sources, including published research, educational content and practical experience. This paper reports the findings of a study that investigated the sources of knowledge or evidence for practice used by psychiatric nurses in Ireland. The paper is part of a larger study, which also investigated barriers, facilitators and level of skills in achieving EBP among Irish psychiatric nurses. Data were collected in a postal survey of a random sample of Irish psychiatric nurses using the Development of Evidence-Based Practice Questionnaire. The findings revealed that the majority of survey respondents based their practice on information which was derived from interactions with patients, from their personal experience and from information shared by colleagues and members of the multidisciplinary team, in preference to published sources of empirically derived evidence. These findings are consistent with those of the previous similar studies among general nurses and suggest that Irish psychiatric nurses face similar challenges to their general nursing counterparts in attaining of EBP.
Sæther, Sverre Georg; Schou, Morten; Stoecker, Winfried
, GLRA1B, DPPX, GRM1, GRM5, DNER, Yo, ZIC4, GAD67, amphiphysin, CV2, Hu, Ri, Ma2, and recoverin. Only one sample was positive (antirecoverin IgG). The present findings suggest that serum onconeural antibody positivity is rare among patients acutely admitted for inpatient psychiatric care. The clinical...
Jansen, Gerard J.; Middel, Berry; Dassen, Theodoor; Reijneveld, Menno S A
Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude
Gotlib, Dorothy; Bostwick, Jolene R; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E; Fluent, Thomas
To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery.
Counselling is increasingly described in the literature as an important part of the psychiatric nurse's role. Often, the type of counselling described in that literature is of the client-centered type developed by Carl Rogers. This report outlines the philsophical position known as existentialism and offers suggestions as to how that philosophy may be used to develop a more vigorous and more egalitarian approach to counselling in nursing.
Child abuse affects hundreds of thousands of children in the United States each year. The effects from maltreatment extend beyond the physical injuries-the lasting effects on the child's mental health can be lifelong. Psychiatric nurses have a vital role to play in the prevention, recognition, and treatment of child abuse. [Journal of Psychosocial Nursing and Mental Health Services, 55(11), 16-20.]. Copyright 2017, SLACK Incorporated.
To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.
Grigsby, K A; Megel, M E
Central to nursing practice today is the theme of caring. Yet nursing faculty are themselves experiencing a lack of caring. Faculty frequently voice the complaint that no one in the school of nursing work environment cares about them as they struggle to balance the demands of work with the demands of a personal life. A descriptive phenomenological approach was used to facilitate understanding of the caring experiences of nurses who teach. The question guiding this study was, "How do nurse educators experience caring in their work situations?" Nomination and purposive sampling techniques were used to select seven nurse faculty as participants. Unstructured interviews, lasting approximately one hour, were audiotaped and transcribed. Colaizzi's (1978) methodology was used to analyze the resulting data. Resulting themes included: 1) Caring is Connection and 2) Caring is a Pattern of Establishing and Maintaining Relationships. The use of narrative, journaling, and dialogue are suggested as techniques that will help nurse educators experience caring in schools of nursing.
Modified electroconvulsive therapy (ECT) is a controlled medical procedure in which a seizure is induced in an anaesthetized patient to produce a therapeutic effect. ECT is the most acutely effective treatment available for affective disorders and is more effective than antidepressant drugs. Although in use for 70 years, ECT continues to attract controversy and there is considerable stigma associated with its use that often overshadows the empirical evidence for its effectiveness. One way to overcome this is for health professionals to be educated about contemporary ECT practice. Patients need to make informed decisions when consenting to ECT and this process can be influenced by preconceived ideas and scientific fact. It is, therefore, essential that nurses possess sufficient information to help patients make rational and informed treatment decisions and be able to care for both the clinical and psychological needs of patients treated with ECT. This review outlines the nursing role in ECT and summarizes the main aspects of contemporary ECT practice relevant to general and psychiatric nursing practice.
Garwood, Janet K
The current longitudinal, descriptive, and correlational study explored which traditional teaching strategies can engage Millennial students and adequately prepare them for the ultimate test of nursing competence: the National Council Licensure Examination. The study comprised a convenience sample of 40 baccalaureate nursing students enrolled in a psychiatric nursing course. The students were exposed to a variety of traditional (e.g., PowerPoint(®)-guided lectures) and nontraditional (e.g., concept maps, group activities) teaching and learning strategies, and rated their effectiveness. The students' scores on the final examination demonstrated that student learning outcomes met or exceeded national benchmarks. Copyright 2015, SLACK Incorporated.
Tema, T R; Poggenpoel, M; Myburgh, C P H
Hostile behaviour is becoming a way of life in South Africa. Hostility prevails at all settings, including in the health sector. In a forensic ward psychiatric nurses are subjected to hostile behaviour by the patients. The aim of the present study was to explore and describe the psychiatric nurses' experiences of hostile behaviour by patients in a forensic ward and make recommendations for nurse managers to empower these psychiatric nurses to cope with the patients' aggression. Qualitative, in-depth, phenomenological interviews were conducted with nine psychiatric nurses exposed to hostility from patients in a forensic ward. Recommendations were derived from the results from nurse managers to assist psychiatric nurses. It became apparent from the findings that psychiatric nurses in a forensic ward work in a stressful environment. Hostile behaviour in the forensic ward is consistently experienced by the psychiatric nurses as hindering therapeutic relationships. The psychiatric nurses experienced being disempowered. Psychiatric nurses experience hostile behaviour by patients in a forensic ward as disempowering. IMPLICATIONS FOR NURSE MANAGEMENT: Nurse managers can facilitate psychiatric nurses' empowerment by providing them access to: information, support, resources, opportunity and growth. © 2011 Blackwell Publishing Ltd.
Full Text Available Background: Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. Aims: To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. Materials and Methods: We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12 from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI. Correlations between burnout and sociodemographic/clinical variables were done by Pearson′s r or Spearman′s rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Results: Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at <0.001 level. An internal locus of control was inversely correlated with burnout, but failed to predict it in regression analysis. Conclusion: Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor
Chakraborty, Rudraprosad; Chatterjee, Arunima; Chaudhury, Suprakash
Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12) from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI). Correlations between burnout and sociodemographic/clinical variables were done by Pearson's r or Spearman's rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor. Internal locus of control was also correlated with lower burnout.
Lee, Jai-Yon; Song, Young Ae; Jung, Ji Young; Kim, Hyun Jeong; Kim, Bo Ram; Do, Hyun-Kyung; Lim, Jae-Young
To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in an integrated nursing care services. Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced 'integrated nursing care services'; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. The study applied a cross-sectional survey. In 2016, we conducted a multi-center survey involving 302 registered nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Trial center nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top three desired primary roles for care robots were 'measuring/monitoring', 'mobility/activity' and 'safety care'. 'Reduction in workload', especially in terms of 'other nursing services' which were categorized as non-value-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Care robots are expected to be effective in integrated nursing care services, particularly in 'measuring/monitoring'. Such robots should decrease nurses' workload and minimize non-value-added nursing activities efficiently. No matter how excellent care robots are, they must co-operate with and be controlled by nurses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Karzenowski, Abby; Puskar, Kathy
Motivational Interviewing (MI) is well known and respected by many health care professionals. Developed by Miller and Rollnick (2002) , it is a way to promote behavior change from within and resolve ambivalence. MI is individualized and is most commonly used in the psychiatric setting; it is a valuable tool for the Psychiatric Advanced Nurse Practice Nurse. There are many resources that talk about what MI is and the principles used to apply it. However, there is little information about how to incorporate MI into a clinical case. This article provides a summary of articles related to MI and discusses two case studies using MI and why advanced practice nurses should use MI with their patients.
Marc De Hert
Full Text Available When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering.The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS.A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium.The overall response rate was 70% (N = 627. Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53% or through a colleague (N = 427, 69%. A majority (N = 536, 84% did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%. Nearly unanimously (N = 618, 99%, study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses.The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.
De Hert, Marc; Van Bos, Liesbet; Sweers, Kim; Wampers, Martien; De Lepeleire, Jan; Correll, Christophe U
When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering. The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS). A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium. The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses. The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.
Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.
Cullum, Sarah; Tucker, Sue; Todd, Chris; Brayne, Carol
To compare liaison psychiatric nursing with usual medical care in the management of older medical inpatients who screen positive for depression. Pragmatic randomised controlled trial. Medical wards of UK district general hospital in rural East Anglia. One hundred and thirty-eight medical inpatients aged 65+ screened positive on the 15-item geriatric depression scale (GDS). One hundred and twenty-one out of 138 screen positives entered the trial (58/121 fulfilled criteria for depressive disorder at baseline). (i) A liaison psychiatric nurse assessed participants, formulated a care plan for treatment of their depression, ensured its implementation through liaison with appropriate agencies, and monitored participants' mood and response to treatment for up to 12 weeks. (ii) Usual treatment by hospital and primary care staff. ICD-10 depressive disorder, change in GDS-15 score, quality-adjusted life weeks (QALWs) and patient satisfaction rating. Eighty-six out of 121 participants completed the 16-week trial. Participants in the intervention group were more satisfied with their care, but no significant differences in depressive disorder, depression rating or QALWs gained were found between groups. However, there was a trend towards improvement in the intervention group and effect sizes were higher in the subgroup with depressive disorder. This study is the first RCT to evaluate liaison psychiatric nursing specifically for depression in older medical inpatients; the findings suggest improvement in mental health and quality of life, but a larger trial is required to provide convincing evidence.
Ryu, Jeong-Im; Kim, Kisook
To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.
Fernanda Lima de Paula
Full Text Available Goal: to analyze the possibilities and limits of multiprofessional care in the attention to psychiatric emergencies. Method: it is an analytical study of the type integrative review of the comprehensive literature. Searches were conducted in the Latin American and Caribbean Literature (LILACS and Nursing Database (BDENF databases and in the ScieLo Virtual Library, with the use of Descriptors in Health Sciences (DECs: “Emergency Services, Psychiatric”, “Forensic Psychiatry”, “Psychiatric Rehabilitation”, in the period from 2007 to 2017. Results: after data analysis, two thematic categories emerged: “Possibilities and limits in multiprofessional care for patients in crisis” and “The continuity of care to the patient in crisis by the multiprofessional team”. The studies point out fragility in the management of the multiprofessional team of care to the patients in psychiatric crisis. Therefore, in the substitutive services to the psychiatric hospital, it is necessary to strengthen the care and bonding tools for continuity of treatment after the cases of psychiatric emergency of these patients. Conclusion: this research provided a deepening of the knowledge regarding the challenges of the multiprofessional team in the care of analytical psychiatric emergencies and in relation to the patient in crisis, considering the main multiprofessional actions, understanding how this approach is done and patient follow-up. Descriptors: Emergency Services, Psychiatric. Forensic Psychiatry. Psychiatric Rehabilitation.
Petersson, Lena; Erlingsdóttir, Gudbjörg
When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015. This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice. This is the first of two papers about the implementation of Open Notes in adult psychiatric care in Region Skåne. The objective of this study was to describe, compare, and discuss how different HCPs in adult psychiatric care in Region Skåne expect Open Notes to impact their patients and their own practice. A full population Web-based questionnaire was distributed to psychiatric care professionals in Region Skåne in late 2015. The response rate was 28.86% (871/3017). Analyses show that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between different professionals and attitudes to the Open Notes service. The results show that the psychiatric HCPs are generally of the opinion that the service would affect their own practice and their patients negatively. The most striking result was that more than 60% of both doctors (80/132, 60.6%) and psychologists (55/90, 61%) were concerned that they would be less candid in their documentation in the future. Open Notes can increase the transparency between patients and psychiatric HCPs because patients are able to access their EHRs online without delay and thus, can read notes that have not yet been approved by the responsible HCP. This may be one explanation as to why HCPs are concerned that the service will affect both their own work
Aronson, Keith R
This study assessed the job satisfaction of nurses who work in private psychiatric hospitals. In 1998 and 1999 an anonymous employee satisfaction survey was completed by all 3,024 employees of 39 for-profit psychiatric hospitals owned by the same hospital corporation. Of this total, 546 were registered nurses (RNs). Generally RNs reported fair levels of satisfaction. They reported high levels of pride in their hospitals but low levels of satisfaction with the parent company. Differences in satisfaction were noted as a function of work shift, supervisory role, work setting, and tenure. RNs were less satisfied than employees in all other hospital job classifications. RNs' low level of satisfaction relative to other positions is concerning.
Koivunen, Marita; Välimäki, Maritta; Jakobsson, Tiina; Pitkänen, Anneli
This article describes the systematic process in which an evidence-based approach was used to develop a curriculum designed to support the computer and Internet skills of nurses in psychiatric hospitals in Finland. The pressure on organizations to have skilled and motivated nurses who use modern information and communication technology in health care organizations has increased due to rapid technology development at the international and national levels. However, less frequently has the development of those computer education curricula been based on evidence-based knowledge. First, we identified psychiatric nurses' learning experiences and barriers to computer use by examining written essays. Second, nurses' computer skills were surveyed. Last, evidence from the literature was scrutinized to find effective methods that can be used to teach and learn computer use in health care. This information was integrated and used for the development process of an education curriculum designed to support nurses' computer and Internet skills.
Marco Antonio Zapata Sampedro; Laura Castro Varela
The standardized nursing care plan can be used as a means through which the nurse will assess and identify the particular needs of the blood donor.To draw up the care plan, we have conducted the evaluation on the basis of the Marjory Gordon’s functional health patterns.The more prevailing diagnosis according to the NANDA taxonomy have been identified, results have been established according to the NOC (Nursing Outcomes Classification) taxonomy, and nursing interventions have been suggested ac...
Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin
AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...
Hubbard, Grace B; Beeber, Linda; Eves, Erin
The purpose of this study was to validate five concepts central to secondary traumatization (ST) using narratives of psychiatric mental health advanced practice nurses. The study was designed as a directed content analysis of narrative notes (N-30). Consistency was found between narrative notes and the concepts. This study revealed that exposure and vulnerability precede empathic engagement, reaction, and alteration/transformation. The bidirectional outcome of alteration/transformation suggested that conditions leading to ST could have a positive outcome. Failure to recognize symptoms of ST and provide reflective supervision may compromise the nurse's ability to maintain a work-life balance and provide quality patient care. © 2015 Wiley Periodicals, Inc.
A.A. Tjale; J. Bruce
Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...
Zeng, Jiao-Ying; An, Feng-Rong; Xiang, Yu-Tao; Qi, Yun-Ke; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Yu, Liu-Yang; Ding, Yan-Ming; Tang, Wai-Kwong; Wu, Ping-Ping; Hou, Zhi-Jiaolong; Chiu, Helen F K
This study examined the frequency of violence on nurses in Chinese psychiatric hospitals and explored its risk factors and impact on nurses' quality of life (QOL). A survey was conducted with 387 frontline psychiatric nurses in China. Information about experience of workplace violence in the past 6 months, type of workplace violence, and demographic characteristics was collected by a questionnaire. Altogether 319 (82.4%) of 387 nurses reported having experienced at least one type of violent event in the past 6 months. The prevalence of sexual assault, physical and verbal harassment was 18.6%, 61.5% and 78.6%, respectively. Compared to those with no exposure to violence, nurses who were exposed to violence had lower QOL in both the physical and mental domains. Significant predictors of violence against nurses are male sex, receiving college level or higher education and working on rotating duty were independently associated with high risk of violence. Workplace violence against psychiatric nurses commonly occurs in China. Considering the deleterious effects of violence, comprehensive strategies from the perspective of nursing education and training, organizational policy, patient care and staff support are recommended to promote occupational safety in psychiatric settings in China. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Vandewalle, Joeri; Malfait, Simon; Eeckloo, Kristof; Colman, Roos; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann
The World Health Organization highlights the need for more patient participation in patient safety. In mental health care, psychiatric nurses are in a frontline position to support this evolution. The aim of the present study was to investigate the demographic and contextual factors that influence the willingness of psychiatric nurses to share power and responsibility with patients concerning patient safety. The patient participation culture tool for inpatient psychiatric wards was completed by 705 nurses employed in 173 psychiatric wards within 37 hospitals. Multilevel modelling was used to analyse the self-reported data. The acceptance of a role wherein nurses share power and responsibility with patients concerning patient safety is influenced by the nurses' sex, age, perceived competence, perceived support, and type of ward. To support nurses in fulfilling their role in patient participation, patient participation-specific basic and continuing education should be provided. Managers and supervisors should recognize and fulfil their facilitating role in patient participation by offering support to nurses. Special attention is needed for young nurses and nurses on closed psychiatric wards, because these particular groups report being less willing to accept a new role. Ward characteristics that restrict patient participation should be challenged so that these become more patient participation stimulating. More research is needed to explore the willingness and ability of psychiatric nurses to engage in collaborative safety management with patients who have specific conditions, such as suicidal ideation and emotional harm. © 2017 Australian College of Mental Health Nurses Inc.
Anttila, Minna; Koivunen, Marita; Välimäki, Maritta
This paper is a report of a study to describe nurses' experiences of information technology-based standardized patient education in inpatient psychiatric care. Serious mental health problems are an increasing global concern. Emerging evidence supports the implementation of practices that are conducive to patient self-management and improved patient outcomes among chronically ill patients with mental health problems. In contrast, the attitude of staff towards information technology has been reported to be contradictory in mental health care. After 1 year of using an Internet-based portal (Mieli.Net) developed for patients with schizophrenia spectrum psychosis, all 89 participating nurses were asked to complete questionnaires about their experiences. The data were collected in 2006. Fifty-six participants (63%) returned completed questionnaires and the data were analysed using content analysis. Nurses' experiences of the information technology-based standardized patient education were categorized into two major categories describing the advantages and obstacles in using information technology. Nurses thought that it brought the patients and nurses closer to each other and helped nurses to provide individual support for their patients. However, the education was time-consuming. Systematic patient education using information technology is a promising method of patient-centred care which supports nurses in their daily work. However, it must fit in with clinical activities, and nurses need some guidance in understanding its benefits. The study data can be used in policy-making when developing methods to improve the transparency of information provision in psychiatric nursing.
With increased recognition by government, health administrators, and clinicians of the need to simultaneously contain health expenditure, improve the productivity and efficiency of health services and maintain quality of patient care, applications of casemix funding have been advocated as an alternative means of financing acute hospital care. Currently in Australia, the Commonwealth's casemix development program is encouraging the States and Territories to participate in certain casemix initiatives. Acute psychiatric hospital care and treatment have been excluded from the initial stages of the implementation of casemix in recognition of a number of inherent obstacles or challenges affecting the utility and accuracy of casemix in funding the psychiatric sector. Despite anecdotal claims that the reduced length of stay that often occurs under casemix payment systems may negatively impact upon the quality of care and patient outcomes, to date little empirical research has been directed towards measuring the potential impact of psychiatric casemix on the quality of patient care. Psychiatry cannot afford to ignore the casemix debate on account of its current exclusion from the early phases of implementation. To do so is to run the risk of having casemix imposed at some later stage in the absence of consultation. In the meantime it is vital that mental health professionals, including nurses, participate in the development and implementation of casemix, and contribute to research aimed at increasing or maximizing the relevance of casemix to the funding of psychiatric services.
This study explored registered psychiatric nurses\\' (RPNs\\') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants\\' responses to the SPIRS. The findings provide further insight on nurses\\' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Full Text Available This study explored registered psychiatric nurses' (RPNs' interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD. A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the “staff-patient interaction response scale” (SPIRS. Four themes emerged following data analysis: “challenging and difficult,” “manipulative, destructive and threatening behaviour,” “preying on the vulnerable resulting in splitting staff and other service users,” and “boundaries and structure.” Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
Full Text Available Aim: To determine the incidence rate of forms of inpatient aggression towards nurses who working on psychiatric wards; to identify their attitude to patient aggression, to the factors that condition the occurrence and management of aggression. To determine the differences between nurses in relation to educational training aimed at the issue of patient aggression. Design: Quantitative cross-sectional study. Methods: Selection of respondents was deliberate. The sample comprised 223 nurses with an average of 21.27 (± 11.41 years of clinical practice. Data collection was implemented by means of the self-assessment scales: Violence and Aggression of Patients Scale (VAPS, Attitude Towards Aggression Scale (ATAS, The Management of Aggression and Violence Attitude Scale-Likert (MAVAS-L. Results: 98.58% experienced inpatient aggression in the course of the previous year. Negative attitudes to patient aggression predominated in the sample. Nurses expressed strongest agreement with the idea that internal factors foster patient aggression. Regarding methods of aggression management, nurses expressed strongest agreement with the use of medical therapy and restraints. They held a neutral attitude towards the use of non-physical methods. The age of nurses had an effect on how strongly they agreed with the importance of internal factors in prompting patient aggression and with the use of medical therapy and restraints. Conclusion: A high percentage of nurses have had personal experience of various forms of patient aggression. Negative attitudes to aggression predominated in our sample of nurses, emphasizing the influence of internal factors. The attitude of nurses towards patient aggression influences the selection of aggression management strategies.
Zargham-Boroujeni, Ali; Maghsoudi, Jahangir; Oreyzi, Hamid Reza
Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients' strengths, and experts confirmed these findings. Our findings indicate that patients' own strengths are a pivotal factor in getting through their illness from their perspective. Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients' strengths in their care. It is suggested that the theoretical and practical aspects of patients' strengths be incorporated in nursing school curricula.
Full Text Available Background: Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. Materials and Methods: In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Results: Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients′ strengths, and experts confirmed these findings. Our findings indicate that patients′ own strengths are a pivotal factor in getting through their illness from their perspective. Conclusions: Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients′ strengths in their care. It is suggested that the theoretical and practical aspects of patients′ strengths be incorporated in nursing school curricula.
Baum, Alexander; Kagan, Ilya
The aim of this study was to investigate: (a) the association between socio-demographic variables, job satisfaction and intent to leave among hospital psychiatric nurses, and (b) the differences in the above between psychiatric nurses working on closed and open wards. After receiving ethical approval, a convenience sample of 52 (70% of total nursing staff) was drawn from psychiatric nurses in a large Israeli psychiatric hospital (95% response rate). The sample completed anonymously a self-administered structured questionnaire. A negative correlation was found between job satisfaction and intent to leave and between age, all categories of seniority, and intent to leave. Closed-ward nurses reported a higher intent to leave psychiatric nursing. Nurses under 35 reported a significantly higher intent to leave psychiatric nursing than nurses over 35. Job satisfaction was significantly higher among full-time nurses than part-time. Psychiatric hospitals need to pay attention to all factors associated with workers' readiness to leave. Given the widespread shortage of nurses, it is especially important that they address the relatively low job satisfaction of both younger and part-time nurses, and the particular stresses that closed-ward nurses work under. Copyright © 2015 Elsevier Inc. All rights reserved.
Lucieli Dias Pedreschi Chaves
Full Text Available ABSTRACT Objective: To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. Method: A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Results: Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Final considerations: Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks.
Psychiatric diseases are common. The effective treatment of a psychiatric disease, its (somatic) side effects and any concurrent somatic diseases is important for the patient’s overall health and wellbeing. The studies conducted in psychiatric patients generally focus on the continuation of
Vedana, Kelly Graziani Giacchero; da Silva, Danielle Maria; Ventura, Carla Aparecida Arena; Giacon, Bianca Cristina Ciccone; Zanetti, Ana Carolina Guidorizzi; Miasso, Adriana Inocenti; Borges, Tatiana Longo
Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated. Aim In this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units. Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism. Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior. This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Buus, Niels; Angel, Sanne; Traynor, Michael
Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....
Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.
Gonge, Henrik; Buus, Niels
AIM: To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. BACKGROUND: Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence...... an intervention group (n = 40) receiving the meta-supervision in addition to attending usual supervision or to a control group (n = 43) attending usual supervision. METHODS: Self-reported questionnaire measures of clinical supervision effectiveness and benefits were collected at base line in January 2012...... and at follow-up completed in February 2013. In addition, a prospective registration of clinical supervision participation was carried out over 3 months subsequent to the intervention. RESULTS: The main result was that it was possible to motivate staff in the intervention group to participate significantly more...
DeCoux Hampton, Michelle
With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma. © 2011 The Author. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Full Text Available Starting points: In Slovenia, the higher education institution for nursing started exploring employability opportunities in nursing care in connection with the achievement of competencies from students’ and employers’ point of view. This article highlights the importance of monitoring nursing graduates’ employability. Its aim is to examine the employability of nursing care graduates based on the self-evaluation of competences obtained during the last study year and to establish a link between the self-evaluation of competences and students’ academic performance.
Schel, Sandra Helena Hendrika; Bouman, Yvonne Helena Alexandra; Bulten, Berend Hendrik
To compare quality of life (QoL) ratings of long term forensic psychiatric care patients with the ratings of psychiatric nurses, in which the nurses indicate how they think the patient would answer. Agreement on QoL-scores according to the Forensic inpatient Quality of Life Questionnaire (FQL) was investigated for seventy- seven pairs of patients and psychiatric nurses from two forensic psychiatric long-care facilities where QoL is seen as an important treatment goal. This study also examined whether the amount of agreement was related to specific patient characteristics and characteristics of the patient- psychiatric nurse relationship. On group level, only small and mostly non-significant differences were found between patients' and psychiatric nurses' mean QoL scores. However, pairwise comparisons revealed poor agreement between patients' and nurses' QoL scores for half of the domains and moderate agreement on the other half of the domains, except for Leave, which was the only domain on which patients and their nurses had similar scores. Patient characteristics such as type of offence and type of psychopathology were negligibly related to the level of agreement. However, characteristics of the patient-nurse relationship such as age of the nurse and length of the patient-nurse relationship did influence the amount of consensus between patients' and proxies' QoL-scores significantly. Nurses were not sufficiently able to accurately estimate their patients' QoL experience and could probably benefit from a training aimed at assessing QoL of their patients and how to support their patients in optimizing their QoL themselves. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Stigma can complicate people’s mental health problems by affecting different sides of personal life, increasing negative attitudes, causing discriminatory behavior towards them, and reducing the chances of recovery and returning to normal life. This research aims to compare the stigma of mental illness among nurses working in psychiatric and non-psychiatric wards in Tabriz University of Medical Sciences. A total of 240 nurses participated in this descriptive and analytic study. The data were collected using a demographic questionnaire and the Community Attitudes towards the Mentally Ill (CAMI Scale, which is a 40-item self-report questionnaire. All data were analyzed using SPSS 13. The majority of nurses have a medium level of stigma toward people with mental illness, and there is no significant relation between the type of wards and mean stigma scores. After eliminating factors such as mental illness in nurses and their families, it seems that only working with people with mental illness in psychiatric wards is not enough to create a positive attitude toward them. Additionally, the less physical activity and taking advantage of legal benefits of work hardship for psychiatric nurses, low income, and stigma toward psychiatric nursing, probably may make a difference in inclining to work in psychiatry ward between the two groups in spite of relatively equal stigma scores.
Petersson, Lena; Erlingsdóttir, Gudbjörg
This is the second of two papers presenting the results from a study of the implementation of patient online access to their electronic health records (here referred to as Open Notes) in adult psychiatric care in Sweden. The study contributes an important understanding of both the expectations and concerns that existed among health care professionals before the introduction of the Open Notes Service in psychiatry and the perceived impact of the technology on their own work and patient behavior after the implementation. The results from the previously published baseline survey showed that psychiatric health care professionals generally thought that Open Notes would influence both the patients and their own practice negatively. The objective of this study was to describe and discuss how health care professionals in adult psychiatric care in Region Skåne in southern Sweden experienced the influence of Open Notes on their patients and their own practice, and to compare the results with those of the baseline study. We distributed a full population Web-based questionnaire to psychiatric care professionals in Region Skåne in the spring of 2017, which was one and a half years after the implementation of the service. The response rate was 27.73% (699/2521). Analyses showed that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between health professional groups and attitudes to the Open Notes Service. A total of 41.5% (285/687) of the health care professionals reported that none of their patients stated that they had read their Open Notes. Few health care professionals agreed with the statements about the potential benefits for patients from Open Notes. Slightly more of the health care professionals agreed with the statements about the potential risks. In addition, the results indicate that there was little impact on practice in terms of longer appointments or health care professionals having to address patients
Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced b...... knowledge influenced processes of clinical decision-making among the nurses as the game added to a distorted widening of a 'fictional distance' between patients and the representations produced by the nurses.......Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced...... by the particular social relations on hospital wards. Empirical data stemming from an extended fieldwork at two Danish psychiatric hospital wards were interpreted using interactionistic theory and the metaphor: 'the game of clinical knowledge'. The results indicated that the nurses' production of clinical knowledge...
Fluoresceinic angiography of the ocular fundus is a diagnostic technique to study retinal and choroidal circulation. This technique consists of parenteral administration of 500 mg of sodium fluorescein 10% and photographing the fluorescence in the eye vessels. Although this substance is fairly safe, it may also produce mild, moderate or severe local and/or general adverse reactions. The nursing process is routinely used in hospital units but not always in outpatient clinics, even through the use of invasive procedures with intravenous medication administration is common. Therefore, nurses, as those reponsible for intravenous administration, should use the nursing process to guarantee the quality of care required by the patient. To do this, we describe an individualized care plan based on evaluation by Marjorie Gordon's functional health patterns, NANDA's nursing diagnoses Taxonomy II, Nursing Outcomes Classification (NOC), Nursing Interventions Classifications (NIC) and potential complications of the procedure.
Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness. © 2018 Australian College of Mental Health Nurses Inc.
Koekkoek, B.W.; Meijel, B.K.G. van; Schene, A.H.; Hutschemaekers, G.J.M.
The aim of this paper is to describe and analyse the Dutch community psychiatric nursing profession. In spite of their large numbers, estimated at 2900, Dutch community psychiatric nurses (CPNs) have contributed little to the international literature. The history of the profession reveals a
A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. PMID:23710367
Full Text Available The concept of caring in nursing has changed throughout the years. Nursing has developed to meet the needs of the population and to adapt at the same time to scientific knowledge, which has taken another dimension, and technical demand. Every field in nursing gains new formas as it evolves, namely the mental health and psychiatric fields. We start by describing the dominant beliefs of society in the past regarding mental health. We will then talk about mental patients in Portugal from the 16th Century on (1539-1850 and how they were cared for, underlining the first psychiatric institution - Rilhafoles Hospital. We will elaborate on the more common treatments in psychiatry, the purposes they served and how the nursing staff intervened in their application. Finally, we will put the evolution of nursing care to the mental patients into perspective, from the begining of the 20th century, as well as the development of nursing schools in the field of mental and psychiatric health.
Referencial de cuidar em enfermagem psiquiátrica: um processo de reflexão de um grupo de enfermeiras Referencial de Cuidar en Enfermería Psiquiátrica: un proceso de reflexión de un grupo de enfermeras Psychiatric nursing care reference: a reflective process of a group of nurses
Anna Cristina Cardoso Fontes dos Santos
Humano, Cuidado Profesional de Enfermería; Cuidador profesional; Proceso Educativo; Institucional y des-cuidado que permitieron formular una propuesta de referencia para la práctica del Cuidar en Enfermería a pacientes psiquiátricos institucionalizados de larga permanencia.Qualitative research that had as purpose to construct in conjunction with six head nurses, of a public Psychiatric Institution located in Rio de Janeiro, a theoretical-philosophical reference to be implemented by themselves, in the development of the psychiatric patients' care process. It was made a reflexion process on group dynamics looking for self-knowledge and maturity. This occurred during the development of master thesis (1, advised by Dr. Eloita Pereira Neves. It was used concepts of Humanistic (2 and Bureaucratic Care Theories (3, directives of the Psychiatric Reform and Politics of Mental Health. The data collected were recorded, transcribed, and analyzed according to the content analysis (4. The results pointed to categories of Conceptions related to: Human Being; Professional Nursing Care; Care of the Professional Caregiver; Caring as an Educational Process; Institutional and Carelessness. These allowed formulating a reference proposal for the Nursing Care practice in institutionalized psychiatric patients of long permanence.
Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.
Evans, Jeanne; Bell, Jennifer L; Sweeney, Annemarie E; Morgan, Jennifer I; Kelly, Helen M
The purpose of the study was to gain an understanding of the nursing phenomenon, confidence, from the experience of nurses in the nursing subculture of critical care. Leininger's theory of cultural care diversity and universality guided this qualitative descriptive study. Questions derived from the sunrise model were used to elicit nurses' perspectives about cultural and social structures that exist within the critical care nursing subculture and the influence that these factors have on confidence. Twenty-eight critical care nurses from a large Canadian healthcare organization participated in semistructured interviews about confidence. Five themes arose from the descriptions provided by the participants. The three themes, tenuously navigating initiation rituals, deliberately developing holistic supportive relationships, and assimilating clinical decision-making rules were identified as social and cultural factors related to confidence. The remaining two themes, preserving a sense of security despite barriers and accommodating to diverse challenges, were identified as environmental factors related to confidence. Practice and research implications within the culture of critical care nursing are discussed in relation to each of the themes.
Rose, Donald N; Peter, Elizabeth; Gallop, Ruth; Angus, Jan E; Liaschenko, Joan
The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients. © 2011 International Association of Forensic Nurses.
Moreno-Poyato, Antonio R; Delgado-Hito, Pilar; Suárez-Pérez, Raquel; Leyva-Moral, Juan M; Aceña-Domínguez, Rosa; Carreras-Salvador, Regina; Roldán-Merino, Juan F; Lluch-Canut, Teresa; Montesó-Curto, Pilar
Psychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method. The study will use a mixed method design. Qualitative methodology, through participative action research, will be employed to implement scientific evidence on the therapeutic relationship. A quasi-experimental, one-group, pre-test/post-test design will also be used to quantitatively measure the effectiveness of the implementation of the evidence. Participants will consist of nurses and patients from two psychiatric units in Barcelona. Nurses will be selected by theoretical sampling, and patients assigned to each nurses will be selected by consecutive sampling. Qualitative data will be gathered through discussion groups and field diaries. Quantitative data will be collected through the Working Alliance Inventory and the Interpersonal Reactivity Index. Qualitative data will be analysed through the technique of content analysis and quantitative data through descriptive and inferential statistics. This study will help to understand the process of change in a nursing team working in an inpatient psychiatric ward and will allow nurses to generate knowledge, identify difficulties, and establish strategies to implement change, as well as to assess whether the quality of the care they provide shows a qualitative improvement.
Lee, Mei-Hsiu; Lee, Shui-Chuen; Lee, Shu-Chen
Literature articles and clinical observation suggest disease and environmental factors as primary causes of the low self-esteem and stigmatization that typify most psychiatric patients. These patients are at risk of injury when subjected to inappropriate physical restraint. Hospital staffs, including nurses, are in immediate and close contact with psychiatric patients. Mencius's and Kant's thoughts on human dignity can enhance reflections on clinical nursing practices. Mencius's belief that preserving life is not the most desirable thing and death is not the most hated thing can help nurses realize the human dignity of psychiatric patients by understanding that, as an unrighteous act is more detestable than death, the meaning and value of righteousness are greater than life itself. In light of Kant's views on human dignity, nurses should treat patients as goals rather than means. Exploring such ideas can raise nursing quality, restore a positive sense of humanity to psychiatric patients, and develop nursing values and meaning to a higher plane.
Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K
Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.
Mousa, Marwa Abd El-Gawad Ahmed
Empathy is an ability and skill that can be learned and developed through appropriate education and practice. While the importance of nurses' empathy is widely acknowledged, little is known about the impact of passing through the psychiatric nursing and mental health educational experience at the Faculty of Nursing, Alexandria University on…
Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan
The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.
Buus, Niels; Angel, Sanne; Traynor, Michael
This paper is a report of an interview study exploring psychiatric hospital nursing staff members' reflections on participating in supervision. Clinical supervision is a pedagogical process designed to direct, develop, and support clinical nurses. Participation rates in clinical supervision...... they influence participation rates. Twenty-two psychiatric hospital nursing staff members were interviewed with a semistructured interview guide. Interview transcripts were interpreted by means of Ricoeur's hermeneutic method. The respondents understood clinical supervision to be beneficial, but with very...
Lee, Joyce Yan
In their daily work, psychiatric nurses are subjected to patient-perpetrated verbal and physical aggression. They manage a high level of work stress. As compared to their colleagues working in civil settings, forensic psychiatric nurses may experience different rates of patient aggression and work stress. Such experiences have implications for the mental health and productivity of nursing staff. In inpatient settings, homicide by a patient is a rare event. Representing the most severe f...
Gotlib, Dorothy; Bostwick, Jolene R.; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E.; Fluent, Thomas
Objectives To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Experimental Design Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Principal Observations Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). Conclusions This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery. PMID:28936009
von Essen, L; Sjödén, P O
The present study identified psychiatric inpatient (N = 61) and staff (N = 63) perceptions of most and least important nurse caring behaviors using a modified Swedish version of the CARE-Q instrument (Larson, 1981) and compared the results with data from somatic care (von Essen & Sjödén, 1991a, 1991b). The results demonstrated 13 significant mean between-group differences in the rating of 50 specific CARE-Q behaviors. Two significant mean value differences out of six subscales combining individual items were demonstrated between groups. Psychiatric inpatients considered the cognitive aspect, and somatic inpatients the task-oriented aspect of caring as the most important. Staff, in psychiatric as well as somatic care, considered the emotional aspect of caring as the most important. The results suggest that staff has a relatively invariant, human-oriented perception of caring, irrespective of subdisciplines, while patients' perceptions of caring vary more over specialties.
... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing care. 409.21 Section 409.21 Public Health... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.21 Nursing care. (a) Basic rule. Medicare pays for nursing care as posthospital SNF care when provided by or under the supervision of a registered...
Sunnqvist, Charlotta; Karlsson, Karin; Lindell, Lisbeth; Fors, Uno
Psychiatric and mental health nursing is built on a trusted nurse and patient relationship. Therefore communication and clinical reasoning are two important issues. Our experiences as teachers in psychiatric educational programmes are that the students feel anxiety and fear before they start their clinical practices in psychiatry. Therefore there is a need for bridging over the fear. Technology enhanced learning might support such activities so we used Virtual patients (VPs), an interactive computer simulations of real-life clinical scenarios. The aim of this study was to investigate 4th term nursing students' opinions on the use of Virtual Patients for assessment in a Mental Health and Ill-health course module. We asked 24 volunteering students to practise with five different VP cases during almost 10 weeks before the exam. The participants were gathered together for participating in a written and an oral evaluation. The students were positive to the use of VPs in psychiatry and were very positive to use VPs in their continued nursing education. It seems that Virtual Patients can be an activity producing pedagogic model promoting students' independent knowledge development, critical thinking, reflection and problem solving ability for nurse students in psychiatric care. Copyright © 2016 Elsevier Ltd. All rights reserved.
Silverstein, Christine M
During World War II, psychiatric nurses learned valuable lessons on how to deal with the traumas of war. Using psychohistorical inquiry, this historian examined primary and secondary sources, beyond the facts and dates associated with historical events, to understand why and how psychiatric nurse pioneers developed therapeutic techniques to address the psychosocial and physical needs of combatants. Not only is the story told about the hardships endured as nurses ministered to soldiers, but their attitudes, beliefs, and emotions, that is, how they felt and what they thought about their circumstances, are explored. In this study the lived experiences of two psychiatric nurses, Votta and Peplau, are contrasted to explicate how knowledge development improved care and how this knowledge had an impact on the home front in nursing practice and education, as well as in mental institutions and society, long after the war was won.
Ratzliff, Anna; Norfleet, Kathryn; Chan, Ya-Fen; Raney, Lori; Unützer, Jurgen
With the increased implementation of models that integrate behavioral health with other medical care, there is a need for a workforce of integrated care providers, including psychiatrists, who are trained to deliver mental health care in new ways and meet the needs of a primary care population. However, little is known about the educational needs of psychiatrists in practice delivering integrated care to inform the development of integrated care training experiences. The educational needs of the integrated care team were assessed by surveying psychiatric consultants who work in integrated care. A convenience sample of 52 psychiatrists working in integrated care responded to the survey. The majority of the topics included in the survey were considered educational priorities (>50% of the psychiatrists rated them as essential) for the psychiatric consultant role. Psychiatrists' perspectives on educational priorities for behavioral health providers (BHPs) and primary care providers (PCPs) were also identified. Almost all psychiatrists reported that they provide educational support for PCPs and BHPs (for PCP 92%; for BHP 96%). The information provided in this report suggests likely educational needs of the integrated care psychiatric consultant and provides insight into the learning needs of other integrated care team members. Defining clear priorities related to the three roles of the integrated care psychiatric consultant (clinical consultant, clinical educator, and clinical team leader) will be helpful to inform residency training programs to prepare psychiatrists for work in this emerging field of psychiatry.
Bakar, Abu; Nursalam; Adriani, Merryana; Kusnanto; Qomariah, Siti Nur; Hidayati, Laily; Pratiwi, Ika Nur; Ni'mah, Lailatun
Caring is a behavior of giving holistic assistance to individuals. In fact, this important behavior still has not routinely performed in current nursing practice. Personality and sipirituality are important factors in forming one's caring behavior. Spirituality is a passion or impulse to perform noble action. The objective of this study was to…
Backes, Dirce Stein; Backes, Marli Stein; Erdmann, Alacoque Lorenzini
This study is the result of the project: networks care and social entrepreneurship: the autonomy and social commitment of nurses. The purpose of this qualitative study is to comprehend the meaning of nursing care as a social enterprising practice. The Grounded Theory was used as a methodological reference and the interview, conducted with 35 participants as technique of data collection. Data codification led to the central theme: Viewing Nursing Care as a Social Enterprising Practice. This theme is complemented by the category, characterized the cause condition: the social integration through the creation a political identity that expresses your involvement. The results showed that is necessary to learn and have a deep dialogic knowledge. In order to consolidate popular participation as a citizenship ideal, a critical professional attitude, base don the combination of care with liberty, participation end autonomy.
Yoshizawa, Kaori; Sugawara, Norio; Yasui-Furukori, Norio; Danjo, Kazuma; Furukori, Hanako; Sato, Yasushi; Tomita, Tetsu; Fujii, Akira; Nakagam, Taku; Sasaki, Masahide; Nakamura, Kazuhiko
Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression Scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of these results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions.
Sims, Traci T
A lack of emotional skills may affect a nurse's personal well-being and have negative effects on patient outcomes. To compare psychiatric-mental health nurses' (PMHN) scores on the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to a normed population and compare the emotional intelligence (EI) scores of PMHNs using two tools, MSCEIT and Self-Rated Emotional Intelligence Scale (SREIS). Comparative descriptive and correlational study. PMHNs in the study had a higher mean EI compared with that of 5,000 participants in the normed MSCEIT sample. Significant weak correlations were seen between the perceiving and understanding emotion branches of the MSCEIT and SREIS. The current study added data about a sample of PMHN's EI levels in the United States, which may encourage dialog about EI among PMHNs. Future research is needed to examine the relationship between self-report EI tools (e.g., SREIS) and performance tools (e.g., MSCEIT) to determine if they are measuring the same construct.
Gustafsson, Lena-Karin; Stenberg, Maja
It is of importance to understand and communicate caring ethics as a ground for qualitative caring environments. Research is needed on nursing attributes that are visible in nursing leadership since it may give bases for reflections related to the patterns of specific contexts. The aim of this study was to illuminate the meaning of crucial attributes in nursing leadership toward an ethical care of patients in psychiatric in-patient settings. The design of the study was descriptive and qualitative with a phenomenological hermeneutical approach. Participants and research context: The study comprised focus group interviews with nurses working in indoor psychiatric care who participated after giving informed consent. Ethical considerations: Since the topic and informants are not labeled as sensitive and subject to ethical approval, it is not covered by the ethics committee's aim and purpose according to Swedish law. However, careful procedures have been followed according to ethics expressed in the Declaration of Helsinki. When identifying the thematic structures, analysis resulted in three major themes: To supply, including the following aspects: to supply evidence, to supply common space, and to supply good structures; To support, including the following aspects: to be a role model, to show appreciation and care, and to harbor; To shield, including the following aspects: to advocate, to emit non-tolerance of unethical behavior, and to reprove. Leadership is challenging for nurses and plays an important role in ethical qualitative care. These findings should not be understood as a description about nurse manager's role, which probably has different attributes and more focus on an organizational level. Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.
Severinsson, E; Hummelvoll, J K
This study addressed the factors that nursing staff perceived as creating job satisfaction in their working environment in addition to addressing the ethical dilemmas that staff experienced within an acute psychiatric care setting. It also addressed how clinical supervision contributed to job satisfaction among staff as well as the differences between staff who attended and staff who did not attend to clinical supervision. Data were analyzed using descriptive statistics. Overall, the results of this study showed that the factors influencing nurses are related to areas of dissatisfaction, for example, stress and experiences with shortcomings. Factors that contribute to job satisfaction or dissatisfaction were found to be related to the nurses' value systems. The ethical dilemmas that were specifically addressed involved how to care for patients and handle work in relation to patients' autonomy, how to approach the patient, how to provide care against the will of the patient, and what action was ethically right for each particular patient.
McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David
Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important
Nurses are practising in a work environment which is sometimes difficult and which can affect their capacity to supervise students. They may sometimes find themselves taking out their frustration on these students. By being better trained in the specificities of adult learning, frontline professionals and tutors could find it easier to adopt a compassionate care attitude towards nursing students, an essential condition for the development of their skills. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
McLean, Carmen P; Gay, Natalie G; Metzger, David A; Foa, Edna B
Past studies of barriers to HIV care have not comprehensively assessed psychiatric symptoms, and few have assessed barriers to care among people living with HIV (PLWH) who are lost to care (LTC). We examined psychiatric symptoms, barriers to HIV care, and immune functioning in PLWH who were retained in care (RIC; n = 21) or LTC (n = 21). Participants completed diagnostic interviews for posttraumatic stress disorder (PTSD) and other psychiatric disorders, self-report measures of HIV risk behaviors and psychiatric symptoms, and a blood draw to assess viral load. Compared to RIC participants, LTC participants met criteria for a greater number of psychiatric disorders and reported greater depressive symptoms and more barriers to HIV care. There were no group differences in PTSD severity, risk behaviors, or viral load, suggesting that LTC individuals experience greater psychiatric problems and perceive more barriers to care than RIC participants, but are not less likely to have achieved viral suppression.
Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H
Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.
Smith, Kylie M
In 1952, Hildegard Peplau published her textbook Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. This was the same year the American Psychiatric Association (APA) published the first edition of the Diagnostic and Statistical Manual of Mental Disorders (1st ed.; DSM-I; APA). These events occurred in the context of a rapidly changing policy and practice environment in the United States after World War II, where the passing of the National Mental Health Act in 1946 released vast amounts of funding for the establishment of the National Institute of Mental Health and the development of advanced educational programs for the mental health professions including nursing. This article explores the work of two nurse leaders, Hildegard Peplau and Dorothy Mereness, as they developed their respective graduate psychiatric nursing programs and sought to create new knowledge for psychiatric nursing that would facilitate the development of advanced nursing practice. Both nurses had strong ideas about what they felt this practice should look like and developed distinct and particular approaches to their respective programs. This reflected a common belief that it was only through nurse-led education that psychiatric nursing could shape its own practice and control its own future. At the same time, there are similarities in the thinking of Peplau and Mereness that demonstrate the link between the specific social context of mental health immediately after World War II and the development of modern psychiatric nursing. Psychiatric nurses were able to gain significant control of their own education and practice after the war, but this was not without a struggle and some limitations, which continue to impact on the profession today.
Brodell, Elizabeth Becky
Nurses entering the workforce are faced with many challenges, but today the multiple demands of patient care are complicated by a nurse's need to keep abreast of fast-changing technology. This research is universally relevant to nursing practice in educational settings and practice areas because nursing education needs to develop strategies to…
Full Text Available Introduction: Nurses who frequently often contact to patients and most of their time serve patients in 24 hours, have an important role in caring for the patient. Patient satisfaction as quality indicator is the key success for competitiveness of service in hospital. The aim of this research was to develop nursing service quality model based on the nursing performance, nurse and patient satisfaction. Method: The research method used cross sectional study, at 14 wards of Gresik Hospital. Research factors were namely: oganization characteristic (organization culture and leadership, work factors (feedback and variety of nurses work, nurse characteristics (motivation, attitude, commitment and mental model, nursing practice, interpersonal communication, nurse and patient satisfaction. Statistical analysis of study data was analyzed by Partial Least Square (PLS. Results: The results of nursing performance revealed that nurse characteristic were not affected by organization culture and leadership style, nurse characteristics were affected by work factors, nurse characteristics affected nursing quality service (nursing practice, nursing professional, nurse and patient satisfaction, nurse satisfaction did not affect nursing professionals. Discussion: Based on the overall results of the development of nursing care model that was originally only emphasizes the process of nursing care only, should be consider the input factor of organizational characteristics, job characteristics, and characteristics of individual nurses and consider the process factors of nursing care standards and professional performance of nurses and to consider the outcome factors nurse and patient satisfaction. So in general the development model of quality of existing nursing care refers to a comprehensive system of quality.
Zheng, Zhimin; Gangaram, Poornima; Xie, Huiting; Chua, Stephanie; Ong, Samantha Bee Cheng; Koh, Sioh Eng
Job satisfaction ranks highly as one of the main factors influencing turnover rates among nurses. Mental health nursing has been reported to be a particularly stressful specialty, yet little is known about the level of job satisfaction among psychiatric nurses in Singapore. Resilience is defined as a means of adapting to stress at the workplace, and could serve as a factor influencing job satisfaction. The present study aimed to explore the current level of job satisfaction among psychiatric nurses working in the only tertiary psychiatric institution in Singapore, the influencing factors, and the relationship between resilience and job satisfaction. A survey questionnaire consisting of the following was administered to all eligible nurses working in the Institute of Mental Health between the period of 16-24 December 2014: (i) The McCloskey and Mueller Satisfaction Scale; (ii) The Resilience Scale; and (iii) sociodemographic data form. A total of 874 nurses were eligible for participation in the study, and a total of 748 nurses responded, totalling 85.6% response. A mean satisfaction score of 95.21 and mean resilience score of 125.74 were obtained. Mean satisfaction and resilience scores were the highest for nurses with longer working experience and those of older age. A positive and significant association between satisfaction and resilience scores (P = 0.001) was obtained. Psychiatric nurses in Singapore are generally satisfied with their job, but this can be further improved with the strengthening of personal resilience. © 2017 Australian College of Mental Health Nurses Inc.
Full Text Available Objective: Nurses are the most important staff in the health care system, thus, their job satisfaction is important in nursing management. The present study aimed at determining the impact of teaching spiritual intelligence on the job satisfaction of psychiatric nurses.Methods: The participants were divided into 2 groups by random allocation. Data were collected in 3 stages of before intervention, 4 weeks, and 8 weeks post intervention using Brayfield & Rother Job Satisfaction Questionnaire.Results: The results of this study revealed that the mean score of job satisfaction in the experimental group was 65.5±9.9 in the pre intervention stage, which increased to 69.8±6.3 one month after the intervention and to 72.5±8.9 in 2 months after the intervention, and it was significantly more than that of the control group.Conclusions: The job satisfaction rate of the control group decreased admirably in both 1 month and 2 months after the intervention stage. Thus, spiritual intelligence training is an effective method to increase job satisfaction, and it is suggested that managers consider spiritual intelligence training to increase job satisfaction in nurses.
Heydari, Abbas; Meshkinyazd, Ali; Soudmand, Parvaneh
Objective: Nurses are the most important staff in the health care system, thus, their job satisfaction is important in nursing management. The present study aimed at determining the impact of teaching spiritual intelligence on the job satisfaction of psychiatric nurses. Method: The participants were divided into 2 groups by random allocation. Data were collected in 3 stages of before intervention, 4 weeks, and 8 weeks post intervention using Brayfield & Rother Job Satisfaction Questionnaire. Results: The results of this study revealed that the mean score of job satisfaction in the experimental group was 65.5±9.9 in the pre intervention stage, which increased to 69.8±6.3 one month after the intervention and to 72.5±8.9 in 2 months after the intervention, and it was significantly more than that of the control group. Conclusion: The job satisfaction rate of the control group decreased admirably in both 1 month and 2 months after the intervention stage. Thus, spiritual intelligence training is an effective method to increase job satisfaction, and it is suggested that managers consider spiritual intelligence training to increase job satisfaction in nurses.
Self harm in the absence of expressed suicidal intent is an under explored area in psychiatric nursing research. This paper reports on findings of a study undertaken in two acute psychiatric inpatient units in Ireland. The purpose of the study was to gain an understanding of the practices of psychiatric nurses in relation to people who self harm, but who are not considered suicidal. Semi structured interviews were held with eight psychiatric nurses. Content analysis revealed several themes. For the purpose of this paper the prevention and intervention strategies psychiatric nurses engage in when working with non-suicidal self harming individuals are presented. Recommendations for further research are offered.
Vance, David E.; Dodson, Joan E.; Watkins, Jason; Kennedy, Bridgett H.; Keltner, Norman L.
To successfully negotiate and interact with one’s environment, optimal cognitive functioning is needed. Unfortunately, many neurological and psychiatric diseases impede certain cognitive abilities such as executive functioning or speed of processing; this can produce a poor fit between the patient and the cognitive demands of his or her environment. Such non-dementia diseases include bipolar disorder, schizophrenia, post-traumatic stress syndrome, depression, and anxiety disorders, just to name a few. Each of these diseases negatively affects particular areas of the brain, resulting in distinct cognitive profiles (e.g., deficits in executive functioning but normal speed of processing as seen in schizophrenia). In fact, it is from these cognitive deficits in which such behavioral and emotional symptoms may manifest (e.g., delusions, paranoia). This article highlights the distinct cognitive profiles of such common neurological and psychiatric diseases. An understanding of such disease-specific cognitive profiles can assist nurses in providing care to patients by knowing what cognitive deficits are associated with each disease and how these cognitive deficits impact everyday functioning and social interactions. Implications for nursing practice and research are posited within the framework of cognitive reserve and neuroplasticity. PMID:23422693
Gabay, Pablo M; Fernández Bruno, Mónica
The rehabilitation of severely mentally-ill patients and their return to the community are related to historical progress. Their potential of achieving these goals is higher or lower depending on the presence of more or less stigma attached to their condition. Watts and Bennett have divided psychiatric rehabilitation into three phases: Phase 1: Very little was done because there was not much to be done. Patients were rejected and received mistreatment. Phase 2: Their vulnerability was admitted and protection was given to the disabled; services were provided by charity and voluntary religious institutions; there was no clear distinction between illness and poverty. Phase 3: Modern psychiatric rehabilitation began after the two World Wars in the 20th century, with attempts to modify and to oppose disability with the development of other skills. Psychiatric rehabilitation programs help these patients to resume life in the community and prevent their social isolation. By ensuring continuity of their treatment, rehabilitation programs reduce relapses and hospitalizations, thereby contributing to preserve family life and social inclusion. This reduces treatment costs to both families and communities, while promoting patients' reinsertion and recovery in the community according to their individual needs.
Koivunen, Marita; Välimäki, Maritta; Hätönen, Heli
Nursing professionals have long recognized the importance to practice of research and the value of research evidence. Nurses still do not use research findings in practice. The purpose of this paper was to describe nurses' skills in using literature databases and the Internet in psychiatric hospitals and associations of nurses' gender, age, and job position with their information retrieval skills. The study was carried out in 2004 among nursing staff (N=183) on nine acute psychiatric wards in two psychiatric hospitals in Finland (n=180, response rate 98%). The Finnish version of the European Computer Driving Licence test (ECDL) was used as a data collection instrument. The study showed that there were clear deficits in information retrieval skills among nurses working in psychiatric hospitals. Thus, nurses' competence does not support the realization of evidence-based practice in the hospitals. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff.
Janssens, Astrid; Hayen, Sarah; Walraven, Vera; Leys, Mark; Deboutte, Dirk
Over the years, increasing numbers of children and adolescents have sought help for acute psychiatric problems. The responses to this treatment-seeking behavior are heterogeneous in different settings and nations. This review aimed to provide an answer to the questions "which care should be offered to children and adolescents presenting with a psychiatric emergency or crisis and how should it be organized." We committed a literature review to find out if any recommendations can be made regarding the organization of emergency care for children and adolescents with acute mental health problems. The lack of a clear definition of emergencies or urgencies hampered this review; we note the differences between adult and child or adolescent psychiatry. The theoretical models of care found in the literature are built up from several process and structural components, which we describe in greater detail. Furthermore, we review the main service delivery models that exist for children and adolescents. Currently, emergency psychiatric care for children and adolescents is practiced within a wide range of care models. There is no consensus on recommended care or recommended setting for this population. More research is needed to make exact recommendations on the standardization of psychiatric care for young people in emergency settings.
Lindgren, Britt-Marie; Aminoff, Carina; Hällgren Graneheim, Ulla
This study aimed to describe the features of everyday life in psychiatric inpatient care as experienced by women who self-harm. Participant observations and informal interviews were conducted with six women and were subjected to qualitative content analysis. The major feature of everyday life in psychiatric inpatient care was 'being surrounded by disorder', which consisted of 'living in a confusing environment, being subject to routines and rules that offer safety but lack consistency' and 'waiting both in loneliness and in togetherness'. The nursing staff spent minimal time with the patients and the women turned to each other for support, care and companionship.
Lazignac, Coralie; Ricou, Bara; Dan, Liviu; Virgillito, Salvatore; Adam, Eric; Seyedi, Majid; Cicotti, Andrei; Azi, Amine; Damsa, Cristian
This paper discusses the importance of psychiatric guidelines and the position of the psychiatrist in the management of agitation in the intensive care unit. The use of psychiatric validated scales to assess agitation seems to ameliorate the quality of care in psychiatry, but also in intensive care. Psychiatric experts' recommendations for managing agitation are given, which is useful to create an open discussion with the intensivists. The use of sedative medication to protect the patient, staff and to prevent an escalation of violence remains a personal choice for each practitioner, depending on individual patient needs and context. In the treatment of agitated patients, an equilibrium needs to be found between the subjective dimension and the available data from evidence based medicine.
Temel, M; Kutlu, F Y
Psychiatric nurses should consider the patient's biological, psychological and social aspects. Marjory Gordon's Functional Health Pattern Model ensures a holistic approach for the patient. To examine the effectiveness of Gordon's Functional Health Pattern Model in reducing depressive symptoms, increasing self-efficacy, coping with depression and increasing hope in people with depression. A quasi-experimental two-group pre-test and post-test design was adopted. Data were collected from April 2013 to May 2014 from people with depression at the psychiatry clinic of a state hospital in Turkey; they were assigned to the intervention (n = 34) or control group (n = 34). The intervention group received nursing care according to Gordon's Functional Health Pattern Model and routine care, while the control group received routine care only. The Beck Depression Inventory, Beck Hopelessness Scale and Depression Coping Self-Efficacy Scale were used. The intervention group had significantly lower scores on the Beck Depression Inventory and Beck Hopelessness Scale at the post-test and 3-month follow-up; they had higher scores on the Depression Coping Self-Efficacy Scale at the 3-month follow-up when compared with the control group. The study was conducted at only one psychiatry clinic. The intervention and control group patients were at the clinic at the same time and influenced each other. Moreover, because clinical routines were in progress during the study, the results cannot only be attributed to nursing interventions. Nursing models offer guidance for the care provided. Practices based on the models return more efficient and systematic caregiving results with fewer health problems. Gordon's Functional Health Pattern Model was effective in improving the health of people with depression and could be introduced as routine care with ongoing evaluation in psychiatric clinics. More research is needed to evaluate Gordon's Nursing Model effect on people with depression. Future
Collet, J; de Vugt, M E; Schols, J M G A; Engelen, G J J A; Winkens, B; Verhey, F R J
Working in long-term care is seen as a stressful, physically and mentally demanding occupation, and thus, nursing staff are at risk for work and stress-related diseases. In older patients, psychiatric illnesses often occur in combination with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nurses is unknown. Nursing staff working on specialized units for patients with combined care needs experience high levels of self-efficacy in combination with strong feelings of self-rated competence. Although levels of burnout are relatively low, mental healthcare nursing staff is more at risk for burnout when working in specialized settings for patients with combined care needs than nursing home staff working in specialized settings for these patients. Nursing staff characteristics, such as years of working experience and age, seem more important in relation to staff well-being than patient characteristics in specialized settings for combined care needs. Staff well-being might benefit from specializing care, so that patients with similar care needs are placed together and care is focused. The presence of specialized care units for older patients with combined care needs can allow for both targeted and focused allocation of nursing staff to these units and provision of specific training. Introduction In older patients, psychiatric illnesses frequently exist in tandem with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nursing staff is unknown. To investigate whether care characteristics of patients with combined care needs are related to the mental well-being of nursing staff. Well-being of nursing staff was studied within a larger exploratory observational cross-sectional study that examined the differences and similarities of specialized combined care units
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Wright, David Kenneth; Vanderspank-Wright, Brandi; Holmes, Dave; Skinner, Elise
A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the values of nurses working in forensic psychiatry, and how these values might influence a palliative approach to care for frail and aging patients. Interviews with four nurses working on one of two forensic units of a university-affiliated mental health hospital in an urban area of eastern Canada. Three specific values were found to guide forensic nurses in their care of aging patients that are commensurate with a palliative approach: hope, inclusivity, and quality of life. When we started this project, we wondered whether the culture of forensic nursing practice was antithetical to the values of a palliative approach. Instead, we found several parallels between forensic nurses' moral identities and palliative philosophy. These findings have implications for how we think about the palliative approach in contexts not typically associated with palliative care, but in which patients will increasingly age and die.
Vaaler, A E; Morken, G; Fløvig, J C; Iversen, V C; Linaker, O M
Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intensive care unit (PICU) and not in a psychiatric acute department. In a naturalistic study, one group of consecutively referred patients had access only to the PICU, the other group to the whole acute unit. Data were obtained for 56 and 62 patients using several scales. There were significant differences in reduction of behaviour associated with imminent, threatening incidents (Broset Violence Checklist), and actual number of such incidents (Staff Observation Aggression Scale-Revised) in favour of the group that was treated in a PICU. The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents.
Vincze, M.; Fredriksson, L.; Wiklund Gustin, Lena
Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneu...
Enns, Carol L; Sawatzky, Jo-Ann V
Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
Dressing, Harald; Salize, Hans-Joachim
The aims of this study were to describe and analyse the concepts of provision of mental health services for prison inmates in 24 countries in the European Union and the EFTA. Data were gathered by means of a structured questionnaire that was completed by national experts in the participating countries. This article stresses the different organizational models of mental health care for inmates, different legal standards for screening their mental health status and different pathways to psychiatric care and aftercare. The study revealed serious shortcomings. Even the most rudimentary health reporting standards for mental health care in prison are lacking almost everywhere in Europe. Psychiatric screening and assessment procedures at prison entry and during imprisonment differ substantially and do not fulfil recognized quality standards. In many countries, the appointment of inadequately trained staff to perform such screenings increases considerably the risk that mental disorders or psychiatric needs of the inmates will remain undetected. Furthermore, the pathways to care in the case of an acute psychotic episode differ significantly, since referral to prison hospitals, medical prison wards, forensic hospitals, or general psychiatric hospital are used in various combinations depending on different national legal regulations and on the availability of services or other regional circumstances. Therefore, the collaborating experts place the quality of European prison mental health care into serious question. (c) 2009 John Wiley & Sons, Ltd.
Steenbeek, M; van Baarsen, C; Koekkoek, B
Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. The psychiatric consultations requested were tabulated and were analysed. Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.
Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning. © 2013 John Wiley & Sons Ltd.
The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.
Full Text Available Introduction: The paper presents the organizational measures for managing violence in psychiatric settings and the study that introduces the preliminary success rate of the proposed model. Methods: For the purpose of this study a non-experimental sampling method was employed using a structured questionnaire as a data collection instrument. The sample covered the personnel most frequently exposed to violence namely, the nursing staff in closed and/or intensive psychiatric units in 5 Slovenian psychiatric hospitals, 3 psychiatric homes and 2 special education, and work and care centres. The data were statistically analysed with the SPSS v20 software package, with p < 0.05 indicating statistical significance. Results: The practical part of the functional training was conducted between 2010 and 2013 in specific psychiatric hospitals and wards. In a study carried out in 2013, preliminary results indicating the success rate of the proposed model were obtained. Discussion and conclusions: Health care workers in psychiatry are responsible for providing safe and high quality treatment even in cases of aggressive outbursts, but they lack the necessary functional knowledge to cope with aggression in the workplace. The paper presents an organizational model for ensuring the safety of the patients and the quality of their treatment in case of an aggressive outburst, along with the presentation of the required functional training.
Lecordier, Didier; Jovic, Ljiljana
As a continuation of its work and of the seminar on nursing sciences education in 2014, the “Association de recherche en soins infirmiers” (Arsi) organized a seminar on the 3rd and-4th of June 2016 in Nantes entitled : “nursing : perspectives and foresights”. More than fifty participants from the francophone area representing various sectors of practice : clinical, teaching, management and students gathered to debate and produce benchmarks to support the development of nursing sciences in France and to draw future directions for clinical practice and training. The successive sessions made it possible to reflect, to confront opinions, to make proposals and to identify the terms of the problematic of care and nursing knowledge today and the methodological elements relating to foresight. At the end of this very creative seminar, new avenues of reflection emerged shifting our usual look at the nurse profession. Orientations for training and practice have been defined with different stakes depending on the level of training and professional commitment. The strong links between professional, scientific and academic discipline have also been clarified, highlighting the importance to hold a high theoretical and scientific requirement, rigorous clinical practice, strong professional commitment and effective leadership.
Jansen, Gerard J; Middel, Berry; Dassen, Theo W N; Reijneveld, Menno S A
Little is currently known about the attitudes of psychiatric nurses toward patient aggression, particularly from an international perspective. Attitudes toward patient aggression of psychiatric nurses from five European countries were investigated using a recently developed and tested attitude scale. Data were collected from a convenience sample of 1,769 student nurses and psychiatric nurses. Regression analysis was performed to identify personal and occupational characteristics of the respondents able to predict their attitude toward aggression. Analysis of variance was used to identify significant differences in attitudes between and among countries. Attitude was predicted by sex, contractual status (full vs. part time), and the type of ward on which subjects worked. With one exception (communicative attitude), attitudes differed across countries. More research on attitude formation is needed to determine which factors account for these differences.
Huisman-de Waal, Getty; Feo, Rebecca; Vermeulen, Hester; Heinen, Maud
The aim of the study is to explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. Basic care activities lie at the core of nursing, but are ill-informed by evidence and often poorly delivered. Nursing students' education on basic care might be lacking, and the question remains how they learn to deliver basic care in clinical practice. Descriptive study, using an online questionnaire. Nursing students at the vocational and bachelor level of six nursing schools in the Netherlands were invited to complete an online questionnaire regarding their perception of basic nursing care education in general (both theoretical education and clinical placement), and specifically in relation to nutrition and communication. Nursing students (n=226 bachelor students, n=30 vocational students) completed the questionnaire. Most students reported that they learned more about basic nursing care during clinical placement than during theoretical education. Vocational students also reported learning more about basic nursing care in both theoretical education and clinical practice than bachelor students. In terms of nutrition, low numbers of students from both education levels reported learning about nutrition protocols and guidelines during theoretical education. In terms of communication, vocational students indicated that they learned more about different aspects of communication during clinical practice than theoretical education, and were also more likely to learn about communication (in both theoretical education and clinical practice) than were bachelor students. Basic nursing care seems to be largely invisible in nursing education, especially at the bachelor level and during theoretical education. Improved basic nursing care will enhance nurse sensitive outcomes and patient satisfaction and will contribute to lower healthcare
Tenkanen, Helena; Tiihonen, Jari; Repo-Tiihonen, Eila; Kinnunen, Juha
The importance of core competencies (CC) and their relationship to core interventions in clinical practice guidelines on schizophrenia (CPGS), and the abilities to master these competencies were studied among registered nurses (RN) and practical mental nurses (PMN) in a forensic psychiatric setting. Data were collected from RNs, PMNs, and managers of all five forensic psychiatric facilities in Finland. The research material was obtained by using a 360-degree feedback method. The response rate was 68% (N = 428). The differences between the nurse groups were statistically significant (p ≤ 0.05) regarding the importance of and ability to master the following CCs: (1) pharmacotherapy, (2) knowledge in forensic psychiatry and violent behavior, (3) the treatment of violent patients, (4) processing patient's and own emotion, and (5) need-adapted treatment of the patient. Overall, RNs exceeded PMNs in mastering the CCs, however the principles of the CPGS were not achieved within the current resources in Finland. In summary, RNs, rather than PMNs, should be recruited for work in forensic psychiatric nursing, although a considerable amount of specific training would still be required to achieve competence. Implications of our research indicate that all nurses working in this area need to receive further education in forensic psychiatry and in forensic psychiatric nursing. © 2011 International Association of Forensic Nurses.
Labrague, Leodoro J; McEnroe-Petitte, Denise M; Achaso, Romeo H; Cachero, Geifsonne S; Mohammad, Mary Rose A
This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment. © The Author(s) 2015.
Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith
Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.
Chaves, Lucieli Dias Pedreschi; Mininel, Vivian Aline; Silva, Jaqueline Alcântara Marcelino da; Alves, Larissa Roberta; Silva, Maria Ferreira da; Camelo, Silvia Helena Henriques
To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks. refletir a supervisão de enfermagem como instrumento gerencial do enfermeiro para integralidade do cuidado, considerando suas potencialidades e limitações no cenário atual. estudo reflexivo baseado na formulação discursiva sobre a supervisão de enfermagem, apresentando conceitos e enfoques teóricos e/ou práticos. limitações no exercício da supervisão estão relacionadas à organização dos serviços de saúde embasada no modelo funcional e clínico de atenção, assim como possíveis lacunas no processo de formação do enfermeiro e sobrecarga de trabalho. Quanto às potencialidades, destaca-se a supervisão como instrumento de articulação de ações assistenciais e gerenciais, que pode favorecer integralidade da atenção, estimular atitudes de cooperação e colaboração em equipe, além da corresponsabilização e promoção da educação no trabalho. supervisão de enfermagem pode contribuir para fortalecimento da integralidade do cuidado, pressupondo reflexão cont
Anderson, Jane A; Willson, Pamela
Almost everything we do in nursing is based on our knowledge. In 1984, Benner (From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984) described nursing knowledge as the culmination of practical experience and evidence from research, which over time becomes the "know-how" of clinical experience. This "know-how" knowledge asset is dynamic and initially develops in the novice critical care nurse, expands within competent and proficient nurses, and is actualized in the expert intensive care nurse. Collectively, practical "know-how" and investigational (evidence-based) knowledge culminate into the "knowledge of caring" that defines the profession of nursing. The purpose of this article is to examine the concept of knowledge management as a framework for identifying, organizing, analyzing, and translating nursing knowledge into daily practice. Knowledge management is described in a model case and implemented in a nursing research project.
Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne
Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse...... migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry......, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups...
de Veer, Anke J E; Fleuren, Margot A H; Bekkema, Nienke; Francke, Anneke L
A growing number of new technologies are becoming available within nursing care that can improve the quality of care, reduce costs, or enhance working conditions. However, such effects can only be achieved if technologies are used as intended. The aim of this study is to gain a better understanding of determinants influencing the success of the introduction of new technologies as perceived by nursing staff. The study population is a nationally representative research sample of nursing staff (further referred to as the Nursing Staff Panel), of whom 685 (67%) completed a survey questionnaire about their experiences with recently introduced technologies. Participants were working in Dutch hospitals, psychiatric organizations, care organizations for mentally disabled people, home care organizations, nursing homes or homes for the elderly. Half of the respondents were confronted with the introduction of a new technology in the last three years. Only half of these rated the introduction of the technology as positive.The factors most frequently mentioned as impeding actual use were related to the (kind of) technology itself, such as malfunctioning, ease of use, relevance for patients, and risks to patients. Furthermore nursing staff stress the importance of an adequate innovation strategy. A prerequisite for the successful introduction of new technologies is to analyse determinants that may impede or enhance the introduction among potential users. For technological innovations special attention has to be paid to the (perceived) characteristics of the technology itself.
Full Text Available Since the inception of the decentralisation and integration of psychiatric mental health care services into the general health care delivery system in Botswana, there has never been a study to investigate what community mental health nurses are experiencing due to the policy. Many of these nurses have been leaving the scantily staffed mental health care services in increasing numbers to join other sectors of health or elsewhere since the beginning of the implementation of the policy. During the research study, phenomenological in-depth interviews were conducted with three groups of 12 community mental health nurses altogether. An open central question was posed to each group followed by probing questions to explore and describe these nurses’ experience of the decentralisation and integration of psychiatric-mental health care services. After the data was analysed, related literature was incorporated and guidelines for advanced psychiatric nurses were formulated and described to assist these nurses to cope with the decentralisation and integration of psychiatric-mental health care services. The guidelines were set up for the management of the community mental health nurses who are experiencing obstacles in the quest for mental health which also interfere with their capabilities as mental health care providers.
Kebede, Mihiretu; Endris, Yesuf; Zegeye, Desalegn Tegabu
Even though nursing care documentation is an important part of nursing practice, it is commonly left undone. The objective of this study was to assess nursing care documentation practice and the associated factors among nurses who are working at the University of Gondar Hospital. An institution-based cross-sectional study was conducted among 220 nurses working at the University of Gondar Hospital inpatient wards from March 20 to April 30, 2014. Data were collected using a structured and pre-tested self-administered questionnaire. Data were entered into Epi Info version 7 and analyzed with SPSS version 20. Descriptive statistics, bivariate, and multivariate logistic regression analyses were carried out. Two hundred and six nurses returned the questionnaire. Good nursing care documentation practice among nurses was 37.4%. A low nurse-to-patient ratio AOR = 2.15 (95%CI [1.155, 4.020]), in-service training on standard nursing process AOR = 2.6 (95%CI[1.326, 5.052]), good knowledge AOR = 2.156(95% CI [1.092, 4.254]), and good attitude toward nursing care documentation AOR = 2.22 (95% CI [1.105, 4.471] were significantly associated with nursing care documentation practice. Most of the nursing care provided remains undocumented. Nurse-to-patient ratio, in-service training, knowledge, and attitude of nurses toward nursing care documentation were factors associated with nursing care documentation practice.
Chuang, Shu-Ting; Liu, Yi-Fang; Fu, Zi-Xuan; Liu, Kuang-Chung; Chien, Sou-Hsin; Lin, Chin-Lon; Lin, Pi-Yu
Traditionally, a patient presses the nurse call button and alerts the central nursing station. This system cannot reach the primary care nurse directly. The aim of this study was to apply a new smartphone system through the cloud system and information technology that linked a smartphone and a mobile nursing station for nursing care service. A smartphone and mobile nursing station were integrated into a smartphone nurse call system through the cloud and information technology for better nursing care. Waiting time for a patient to contact the most responsible nurse was reduced from 3.8 min to 6 s. The average time for pharmacists to locate the nurse for medication problem was reduced from 4.2 min to 1.8 min by the new system. After implementation of the smartphone nurse call system, patients received a more rapid response. This improved patients' satisfaction and reduced the number of complaints about longer waiting time due to the shortage of nurses.
Broderick, Margaret C
BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation
This essay considers Nurse Jackie, one of several recent television shows, including HawthoRNe, and Mercy, that features a nurse as the main character. All 3 shows premiered in 2009 and challenged nursing's longstanding invisibility and misrepresentation on television. Although the plots of each show corrected problematic aspects of nursing's usual media representation, only Nurse Jackie remains on the air. In this paper, I analyze why Nurse Jackie succeeded where the other 2 shows did not, considering the representational politics of care on television and in the national context where health care remains a significant concern. Copyright © 2012 Elsevier Inc. All rights reserved.
Elana, Valérie; Gaborieau, Fabienne; Renault, Valérie
The nurses of the centre for care, support and prevention in addictology (CSAPA) and the addictology liaison and care team (ELSA) at Avicenne hospital in Bobigny play a leading role within the multidisciplinary team. They focus particularly on relational care.
Williamson, Kathleen M
This exploratory study involved the triangulation of qualitative (interview and observation) and quantitative methods (Psychological Empowerment Instrument). This study examined the individual home care nurses' perception of empowerment and how it influences decisions in the home clinical setting. Fifteen nurses were self-selected to participate. All completed an interview, and were observed and given Likert Instrument to complete. A framework analysis was performed to identify mutually exclusive and exhaustive emergent themes and patterns within the data. Home care nurses described that enpowerment is in the interaction between nurse and patient, and nurse and health care provider. Empowered is defined as being independent, confident, trusting, and comfortable with providing quality care. Home health care nurses believe that having the ability to practice collaboratively and build professional relationships was essential. Nurses in this study perceived empowerment as having meaning, choice, and competence in their job.
Li, Jin-Biau; Tsai, Sing-Ling
Evidence-based nursing science has identified psychological recovery, partnership, and medication adherence as factors that have influenced the development of mental health care. This article discusses the process by which mental health care has developed from a medical / rehabilitation-focused model to a model that focuses on patient empowerment. The current model aims to assist patients to achieve self-awareness and to develop coping skills that enhance their motivation to transform. Medical advances have improved the control of psychiatric symptoms. Following the introduction of 2nd generation antipsychotics, patients were invited to establish decisions related to these prescription medications. Under the principles of patient-centered service, Taiwanese mental health professionals have changed their relationship with patients from a therapeutic model to a mutual-partnership model. Furthermore, investigations of the therapeutic care of patients with mental illness have used the needs of patients as their starting point and emphasized various aspects of patient and caregiver needs. Taiwanese mental health professionals are searching for a model of mental health care that is superior to the traditional operative framework of medical authority.
van Mierlo, L.D.; van der Wiel, A.; Meiland, F.J.M.; van Hout, H.P.J.; Stek, M.L.; Dröes, R.M.
Objectives: In the Netherlands, many community-dwelling people with dementia and behavioral disturbances and their family caregivers receive mental health care from a community psychiatric nurse (CPN). To promote continuity of care for these persons after moving to a nursing home, a transfer
In June 2008 the UK government, supported by the Royal College of Nursing, stated that nursing care would be measured for compassion. This paper considers the implications of this statement by critically examining the relationship of compassion to care from a variety of perspectives. It is argued that the current market-driven approaches to healthcare involve redefining care as a pale imitation, even parody, of the traditional approach of the nurse as "my brother's keeper". Attempts to measure such parody can only measure artificial techniques and give rise to a McDonald's-type nursing care rather than heartfelt care. The arguments of this paper, although applied to nursing, also apply to medicine and healthcare generally.
Weiskopf, Constance S
The aim of this paper is to report the findings of a study of the experience of caring for prisoners through examining the everyday experience of nurses' delivering health care to inmate patients in a correctional setting. Prisons are most often viewed as places for punishment, while the goals of health and healing, and prevention of diseases in correctional facilities are often neglected. Nurses who deliver health care to prisoners are challenged to do so in a caring relationship that will facilitate their health and healing. The literature on the nature of prison nursing indicates that delivering health care to inmates must be carefully balanced against the need for security, and is affected by factors such as custody staff values, staff education, nursing management, and organizational practices. In-depth interviews were carried out with nine Registered Nurses who had been employed in a variety of correctional institutions throughout their careers, and analysed thematically using Colaizzi's phenomenological method. Findings. Nurses' caring was experienced as an attempt to negotiate the boundaries between the cultures of custody and caring. Facing complex challenges and a number of limitations on the nurse-patient relationship, nurses strived to find a way to care for their inmate patients. Environmental risk meant that caution and vigilance were essential and these nurses demonstrated courage and persevered for the sake of their inmate patients. The findings make clear the challenging and frustrating experience of nurses' caring for inmate patients in restrictive settings. As a result, there are implications for nursing practice, education, and research to assure the best possible health outcomes for inmate patients, the integrity of caring nursing practice, and the safety of both nurses and patients.
Borgès Da Silva, Roxane; Brault, Isabelle; Pineault, Raynald; Chouinard, Maud-Christine; Prud'homme, Alexandre; D'Amour, Danielle
Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Results indicated that systematic follow-up of patients by nurses improved patients' experience of care in terms of accessibility. Using nurses' scope of practice to its full potential is a promising avenue for enhancing both patients' experience of care and health services efficiency.
White, Donna M; Hand, Mikel
The failure of nursing schools to integrate spiritual nursing care education into the curriculum has contributed to a lack in nurses' spiritual care ability. Developing, integrating, and testing a Spiritual Care Nursing Education strategy in an Associates of Science nursing program significantly increased the perceived spiritual care competence of student nurses. Utilizing a faculty team to develop learning activities to address critical spiritual care attributes offers a method to integrate spiritual nursing care content throughout the curriculum in ASN and BSN programs.
Shattell, Mona; Bartlett, Robin; Beres, Kyle; Southard, Kelly; Bell, Claire; Judge, Christine A; Duke, Patricia
The inpatient environment is a critical space for nurses and patients in psychiatric settings. In this article, we describe nurses' and patients' perceptions of the inpatient environment both before the removal of a Plexiglas enclosure around a nurses' station and after its removal. Nurses had mixed feelings about the enclosure, reporting that it provided for confidentiality and a concentrated work space but also acknowledged the challenge of the barrier for communication with their patients. Patients unanimously preferred the nurses' station without the barrier, reporting increased feelings of freedom, safety, and connection with the nurses after its removal. It is important to consider the implications of environmental decisions in inpatient settings in order to promote a healthy workplace and healing environment for all community members. © The Author(s) 2015.
Madathil, Renee; Heck, Nicholas C; Schuldberg, David
It is important to consider ways in which nurses can be protected from experiencing the effects of burnout. This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout. Eighty-nine psychiatric nurses from Montana and New York hospitals completed an online survey that assessed their work-related experiences. Overall, results of this study indicate that the participants were experiencing high levels of emotional exhaustion and depersonalization when compared to a normative sample of mental health workers. Results also showed that leadership style and work role autonomy are likely to be environmental factors that protect against burnout in nurses. Finally, it was shown that the relationship between depressive symptoms and the burnout component of personal accomplishment may be influenced by nurses' perceptions of the leadership style in their work environment. These findings are important because nurse supervisor leadership styles and amount of autonomy are characteristics of the work environment that may be amenable to change through training and intervention. Copyright © 2014 Elsevier Inc. All rights reserved.
Lilly, Mary LuAnne; Hermanns, Melinda; Crawley, Bill
In psychiatric-mental health, creating an innovative strategy to help students learn content that may not be frequently seen in a clinical setting is challenging. Thus, simulation helps narrow this gap. Using Kirkpatrick and Kirkpatrick's model of evaluation to guide the current study, faculty contacted baccalaureate nursing program graduates who completed a psychiatric-mental health clinical simulation scenario featuring a hanging suicide and wrist cutting suicide attempt scenario in the "Behind the Door" series as part of the clinical component of their undergraduate psychiatric-mental health course. Eleven nurses responded to a survey regarding their post-graduate encounters with these types of clinical situations, and their perception of recall and application of knowledge and skills acquired during the simulation experience to the clinical situation. Nursing graduates' responses are expressed through three major themes: emotional, contextual/behavioral, and assessment outcomes. Data from the survey indicate that nursing graduates perceived the "Behind the Door" simulations as beneficial to nursing practice. This perception is important in evaluating knowledge transfer from a simulation experience as a student into application in nursing practice. [Journal of Psychosocial Nursing and Mental Health Services, 54(10), 40-45.]. Copyright 2016, SLACK Incorporated.
Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided. © 2015 The Author(s).
Rooddehghan, Zahra; Yekta, Zohreh Parsa; Nasrabadi, Alireza N
Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values. The present research sought to explore aspects of rationing nursing care in Iran. This study applied qualitative content analysis, a method to explore people's perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants. According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses' feeling of guilt. Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people's lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon
Self-reflection is an essential element of reflective practice for group facilitators. However, this element typically exists largely at the personal level and is not addressed in group dialogues of nurses. The purpose of this study was to explore the self-reflection of psychiatric nurses in a supervision group. A phenomenological approach was used to investigate the dialogues across 12 sessions in terms of discussion content and the reflective journals of the psychiatric nurse participants. The findings showed that two forms of self-reflection included: Embodied self-reflection derived from the physical sensibility and discursive self-reflection derived from the group dialogues. The embodied and discursive self-reflections promote self-awareness in nurses. The embodiment and initiation in the group facilitates the process of self-becoming through the group dialogue, which promotes self-examination and self-direction in healthcare professionals.
Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.
Monareng, Lydia V
Although the concept 'spiritual nursing care' has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech's eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result 'caring presence' was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.
Eliason, Michele J.
Argues that nursing practice and theory cannot be ethical unless cultural factors are taken into consideration and that ethical/transcultural nursing is central to the philosophy and practice of nursing. (Author)
Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh
Background Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. Objectives This study aimed to audit nursing care based on a nursing process model. Patients and Methods This was a cross-sectional descriptive study in which a nursing audit checkl...
Rønneberg, Unni; Walby, Fredrik A
Psychiatric institutions (hospitals and out-patient clinics) are obliged to report cases of suicide to the authorities, but it has not been known to what extent this obligation has been fulfilled. The Norwegian Board of Health Supervision wished to provide an overview of reporting frequencies, descriptions of the extent of the problem, reasons for suicide in patients undergoing psychiatric treatment, whether the institutions use these occurrences to improve the quality of their work and how these cases were handled by the 18 county medical officers. The county medical officers completed registration forms and closing letters for each reported case of suicide committed by patients in psychiatric care (in 2005 and 2006), and sent these documents to the Norwegian Board of Health Supervision. 34/176 (19.3%) suicides were not reported according to the requirements. Almost none of the institutions seemed to use the occurrences in their work to improve quality. There were large differences between the counties both with respect to the number of - and the handling of the reports. The psychiatric hospitals and out-patient clinics must fulfil their obligation to report suicides to the authorities to a larger degree, and to use such occurrences in their work to prevent suicides.
‘Values are principles and standards that have meaning and worth to an individual, family, group, or community’ (Purnell & Paulanka 1998: 3). Values are central to the care provided by nurses. The provision of nursing care within the context of value clarification, has been explored from various...... perspectives, however, as values vary within cultures, there is a limited range of studies reflecting on Saudi Arabian nurses’ perspectives of nursing care. Through a Heideggerian phenomenological research design, six nurses were enrolled through purposive sampling. Semi-structured, in-depth interviews, which...... were audio tape-recorded, were chosen as the methods of data collection. A seven stage framework approach was applied to analyse and organise the research findings in three conceptual themes: values in context of Islam, the nurse-patient relationship, and identity’s influence on being in the world...
Research on recovery from mental illness and the influence of compulsory psychiatric institutional care has revealed the complexity of this concept. There is also limited knowledge regarding the impact of gender-role expectations in these contexts, and how such expectations may influence both the care and individuals' recovery processes. To explore women's and men's perceptions of the impact of compulsory inpatient care on recovery from severe mental illness. Grounded theory was used to analyse 30 first-person accounts of recovery from mental illness, elicited via interviews with individuals who had been compulsorily treated in hospital and diagnosed with a severe mental illness. Inpatient care at an early stage was crucial for the informants' recovery. However, there was ambivalence in their perceptions of the impact of compulsory inpatient care. The narratives confirmed gender differences as well as gender stereotypes. The results have implications for recovery research, in that they emphasise the importance of understanding recovery as a gender-influenced process.
Bakir, Ercan; Samancioglu, Sevgin; Kilic, Serap Parlar
The purpose of this study was to determine the experiences and perceptions of intensive care nurses (ICNs) about spirituality and spiritual care, as well as the effective factors, and increase the sensitivity to the subject. In this study, we examined spiritual experiences, using McSherry et al. (Int J Nurs Stud 39:723-734, 2002) Spirituality and spiritual care rating scale (SSCRS), among 145 ICNs. 44.8% of the nurses stated that they received spiritual care training and 64.1% provided spiritual care to their patients. ICNs had a total score average of 57.62 ± 12.00 in SSCRS. As a consequence, it was determined that intensive care nurses participating in the study had insufficient knowledge about spirituality and spiritual care, but only the nurses with sufficient knowledge provided the spiritual care to their patients.
- effectiveness intertwine with a neo-liberal health policy of a “user- focus and user involvement”,that transforms psychiatric practice. Through the micro-sociological study of professionals working with patients in psychiatry, it is illuminated how patients/clients are objectified and left to care......In psychiatry in Denmark health and social care is being replaced by diagnostic categorisations and a more consumerized relation between the health professionals and patients as self- responsible citizens. Increasing medicalization and New Public Management reforms and standardization for cost...
Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at ...
The thesis deals with integrated dental care in nursing homes. First, the dental treatment needs were ascertained of 432 residents in three Dutch nursing homes that offer integrated dental care. Dentist researchers intra-orally examined the residents and found that 72% required dental treatment.
The refusal of nursing care forms part of the freedom offered to anyone wanting to refuse, consciously and knowingly, any form of nursing care such as washing, the taking of medication or hospitalisation. However, limits are fixed by law as well as by case law. Are we totally free in the expression of our will? Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Roberta Juliane Tono de Oliveira
Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.
Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma
Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.
... 42 Public Health 2 2010-10-01 2010-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual receives...
Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S
Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.
Rhodes, Marilyn K; Morris, Arlene H; Lazenby, Ramona Browder
An award-winning journalist spoke to a group of students during their first month in a baccalaureate nursing program, challenging the nursing profession to abandon its image of nurses as angels and promote an image of nurses as competent professionals who are both knowledgeable and caring. This presentation elicited an unanticipated level of emotion, primarily anger, on the part of the students. This unexpected reaction prompted faculty to explore the students' motivations for entering the nursing profession and their perceptions of the relative importance of competence and caring in nursing. The authors begin this article by reviewing the literature related to motivations for selecting a profession and the contributions of competence and caring to nursing care. Next they describe their survey method and analysis and report their findings regarding student motivations and perceptions of competence and caring in nursing. Emerging themes for motivation reflected nursing values, especially altruism, and coincided with students' beliefs of self-efficacy and goal attainment. Student responses indicated their understanding of the need for competence and revealed idealistic perceptions of caring. The authors conclude with a discussion of these themes and recommendations for student recruitment, curricular emphasis, and future research in this area.
Lukana, Anne; Leena, Salminen; Marjo, Kaartinen; Helena, Leino-Kilpi
The purpose of this literature review was to review the theses (masters, licentiate and doctoral theses) on the history of nursing and caring sciences in Finland. The research questions were as follows: 1.What is the number and characteristics of these historical theses (target groups, methods and sources) on nursing and caring sciences have been produced in Finland? 2.What periods of time have been under investigation in these theses? 3.What topics have been investigated in these theses? The theses on the history of nursing and caring sciences were retrieved from the theses index of the universities that offer education in nursing and caring sciences in Finland. The literature search covered the time period 1979-2010. Altogether, 58 theses were reviewed and analysed via content analysis. Of all of the theses (n = 3969) produced in nursing and caring sciences, 58 of them focused on historical topics (theses examined the history of the 1900s, whereas only a few of them examined time periods before that. The four main topics of the theses were nursing practice, nursing education, nursing management and philosophy of nursing. The most common topic was nursing practice, especially psychiatric nursing. Research on the history of nursing and caring sciences in Finland has received only marginal attention from researchers. This literature review offers a description of the historical research produced on nursing and caring sciences and the topics of interest. In future, it will be necessary to more closely examine several historical topics that have been neglected in the study of nursing and caring sciences. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.
The future of psychiatric community care in Japan requires a medical team for outpatient care to offer support and take responsibility for a region; respecting human rights and supporting high risk patients who have concluded a long-period of hospitalized or repeated involuntary commitment, and for people who suffer from social withdraws over a long period of time. There are over 3,000 private psychiatric outpatient clinics in Japan. Over 400 of them are multifunctional psychiatric outpatient clinics that provide daycare services and outreach activities. In the future, if systematized those clinics entrusted by an administrative organ with performing as a "community mental health center". Multifunctional vertical integration of psychiatric care is possible in Japan to create a catchment area with 24 hours phone service and continued free access.
Christensen, Kirsten Haugaard; Turner, de Sales
Spiritual care perspectives of Danish Nurses The purpose of this study was to explore how Danish registered nurses understand the phenomenon of spiritual care and how their understanding impacts on their interventions with their patients. Nurses are responsible for the provision of care which...... approach rooted in the philosophy of Gadamer was chosen as methodology. In-depth interviews were used as data collection tool, and six registered nurses who worked within hospital settings in Denmark were interviewed. The findings revealed that deep knowing of the patients were essential before nurses...... would engage in provision of spiritual care. The participants acknowledged that their understanding of spirituality influenced their provision of spiritual care, which was recognized as a challenge requiring the nurse’s initiative and courage. Spirituality was primarily understood as a patient’s private...
A. Aziz Alimul Hidayat; M. Kes
Model documentation of assessment and nursing diagnosis in the practice of nursing care management is an integration model in nursing care records, especially records nursing assessment and diagnosis in one format. This model can reduce the duration of the recording in nursing care, and make it easier for students to understand the nursing diagnosis, so that nursing interventions more effective. The purpose of this paper was to describes the form integration documentation of nursing assessmen...
Zietz, Hallie A
Modern therapy for childhood acute leukemia has provided a dramatically improved prognosis over that of just 30 years ago. In the early 1960's survival rates for acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML) were 4% and 3%, respectively. By the 1980's survival rates had risen to 72% for all and 25% to 40% for AML. Today, a diagnosis of all carries an 80% survival rate and as high as a 90% survival rate for some low-risk subtypes. Such high cure rates depend on intense and complex, multimodal therapeutic protocols. Therefore, nursing care of the child with acute leukemia must meet the demands of complicated medical therapies and balance those with the needs of a sick child and their concerned family. An understanding of disease process and principles of medical management guide appropriate and effective nursing interventions. Leukemia is a malignant disorder of the blood and blood- forming organs (bone marrow, lymph nodes and spleen). Most believe that acute leukemia results from a malignant transformation of a single early haematopoietic stem cell that is capable of indefinite self-renewal. These immature cells of blasts do not respond to normal physiologic stimuli for differentiation and gradually become the predominant cell in the bone marrow
Healy, Patricia; Fallon, Anne
This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.
Kelly, Teresa; Howie, Linsey
Psychiatric nurses interested in extending their interpersonal and psychotherapeutic skills sometimes undertake postgraduate training in gestalt therapy. Little is known about how this new knowledge and psychotherapeutic skill base informs their practice. This paper presents the findings of a qualitative study that aimed to explore the influence of gestalt therapy training on psychiatric nursing practice. Within a framework of narrative inquiry, four psychiatric nurses trained in gestalt therapy were invited to tell their stories of training in a gestalt approach to therapy, and recount their experiences of how it influenced their practice. In keeping with narrative analysis methods, the research findings were presented as a collection of four stories. Eight themes were derived from a thematic analysis conducted within and across the four stories. The discussion of the themes encapsulates the similarities and differences across the storied collection, providing a community and cultural context for understanding the individual stories. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Maria Carolina Santos Scozzafave
Full Text Available Objective: To analyze the presence of violence as psychosocial risk from the perception of nurses in a psychiatric hospital, as well as the management strategies implemented to address this risk. Methods: Qualitative study with 25 nurses working in a psychiatric hospital. Data collection was carried out from November 2014 to January 2015 through semi-structured interviews. The data were analyzed and organized into thematic categories following three stages: pre-analysis, exploration of the material and treatment of the results obtained. Participants were identified by the letter "E" and received sequential Arabic numeral numbers, thus guaranteeing the anonymity of the speeches. Thus, they were referenced from E1 to E25. The study was approved by the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing, Brazil. Results: Violence exists in the everyday routine of psychiatric nurses, with the presence of scratches, pinches, kicks, pushes, squeezes against the wall, biting, aggression with the use of objects, among others, and the management strategies consist in appeals to the family, the cinema, music, reading, exercise, therapy, religion. Conclusion: It is important that preventive measures be adopted aimed at promoting safety in the workplace. The discussion on actions to improve the training and practices of nurses working in the mental health area are also important. Keywords: Violence; psychotherapy; emotion; occupational psychiatry; others psychosocial techniques/treatments
Sørensen, Ann Lykkegaard; Mainz, Jan; Poulsen, Birgitte Klindt
will contribute with information regarding the effect of pharmacological training of nurses and possibly improve medication safety for psychiatric patients. Results from this study could serve as evidence, when hospital management makes decisions on how to accede the need for medication reviews as part...... nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... and conducting systematic medication reviews using computer based screening. The effect is evaluated in a controlled interventional study. METHODS: An interventional study including 2 acute psychiatric wards. In one ward nurses’ will receive pharmacological training and the other ward will function as a control...
Gildberg, Frederik Alkier; Bradley, Stephen K.; Hounsgaard, Lise
This article reports on and compares two separate studies of the interactional characteristics of forensic mental health staff and acute mental health staff as they interact with inpatients, respectively. Both studies were conducted using participant observation, along with informal and formal...... interviews. Findings show that both acute and forensic mental health nursing practice is characterized by two overriding themes; ‘trust and relationship-enabling care’ and ‘behavior and perception-corrective care.’ The comparison of the two studies shows no major differences in the characteristics of staff...
Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa
The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.
In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up:  The persistently high number of suicides.  The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals.  The absolute shortage of child psychiatrists.  Little progress with the transition from hospitalization-centered to community-centered medical care.  The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the
Trinier, Ruth; Liske, Lori; Nenadovic, Vera
Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events.
Choi, JiSun; Boyle, Diane K
The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered
Cox, S.; Wark, E.
This and the preceding article (Nursing Mirror, Sept. 1, 1978) form a slightly shortened version of Chap. 5 from Vol. 2 of the book 'Oncology for Nurses and Health Care Professionals', ed. R. Tiffany, (Allen and Unwin, Oct. 1978). Teletherapy was dealt with in part 1. Part 2 is concerned with radiotherapy using radioisotope implants and applicators and unsealed sources, and with surgery and chemotherapy, including side effects of anti-tumour drugs. The physical and psychological effects on the patient of these forms of treatment are discussed, and nursing care and radiological safety precautions for both patients and nursing staff are described. (author)
Cameron, Fiona; Brownie, Sonya
To identify the factors that impact the resilience of registered aged care nurses, that is their capacity to adapt to the physical, mental and emotional demands of working in aged care facilities. This study explored the lived experience of nine registered nurses working in residential aged care facilities on the Sunshine Coast, Queensland, who were asked to reflect on the phenomenon of resilience in the workplace. This study found that clinical expertise, a sense of purpose in a holistic care environment, a positive attitude and work-life balance are important determinants of resilience in aged care nurses. Resilience in nurses in residential aged care facilities is enhanced when they are able to maintain long-term, meaningful relationships with residents. Collegial support that provides opportunities to debrief and validate experiences as well as the use of humour to defuse stress promotes well-being and builds resilience in the workplace.
Nursing is widely considered as an art and a science, wherein caring forms the theoretical framework of nursing. Nursing and caring are grounded in a relational understanding, unity, and connection between the professional nurse and the patient. Task-oriented approaches challenge nurses in keeping care in nursing. This challenge is ongoing as professional nurses strive to maintain the concept, art, and act of caring as the moral center of the nursing profession. Keeping the care in nursing involves the application of art and science through theoretical concepts, scientific research, conscious commitment to the art of caring as an identity of nursing, and purposeful efforts to include caring behaviors during each nurse-patient interaction. This article discusses the profession of nursing as an art and a science, and it explores the challenges associated with keeping the care in nursing.
Zaki, Rania. A.
Nursing stress is considered a problem that affects the practice worldwide. Job stress is a harmful response physically and emotionally when the nurses' skills, resources, and needs could not fulfill the requirement of the job. This study was aimed to assess job stress and self-efficacy among psychiatric nursing working in mental health hospitals…
da Silva, Rafael Celestino; Ferreira, Márcia de Assunção; Apostolidis, Thémistoklis; Brandão, Marcos Antônio Gomes
to propose a conceptual framework for clinical nursing care in intensive care. descriptive and qualitative field research, carried out with 21 nurses from an intensive care unit of a federal public hospital. We conducted semi-structured interviews and thematic and lexical content analysis, supported by Alceste software. the characteristics of clinical intensive care emerge from the specialized knowledge of the interaction, the work context, types of patients and nurses characteristic of the intensive care and care frameworks. the conceptual framework of the clinic's intensive care articulates elements characteristic of the dynamics of this scenario: objective elements regarding technology and attention to equipment and subjective elements related to human interaction, specific of nursing care, countering criticism based on dehumanization.
Sullivan, Debra Henline
Technology is rapidly changing the way nurses deliver patient care. The Health Information Technology for Economic and Clinical Health Act of 2009 encourages health care providers to implement electronic health records for meaningful use of patient information. This development has opened the door to many technologies that use this information to streamline patient care. This article explores current and new technologies that nurses will be working with either now or in the near future. Copyright © 2015 Elsevier Inc. All rights reserved.
Levine, C D; Wilson, S F; Guido, G W
Two hundred members of the American Association of Critical-Care Nurses responded to a mail-out survey done to determine the psychologic profile of critical care nurses in terms of self-esteem, gender identity, and selected personality characteristics. The instruments used were Cattell's 16 PR, the Personal Attributes Questionnaire (PAQ), and the Texas Social Behavior Inventory (TSBI). Their personality factors tended to be aggressive, assertive, competitive, persevering, moralistic, resourceful, and mechanical. The nurses who enjoyed the field most were of the androgynous or masculine type and had high levels of self-esteem. On the basis of these findings, the nurse recruiter or faculty member doing career counseling could assess the personality characteristics, gender identity, and self-esteem levels of interested nurses. The goal would be to identify nurses who would both enjoy the field and remain active in critical care nursing after orientation. The goal could also be to help nurses dissatisfied with critical care nursing to seek means of improving their self-esteem.
Thiele, Jonathan S; Doarn, Charles R; Shore, Jay H
There is a national shortage of psychiatrists, and according to nationally available data, it is projected to get worse. Locum tenens psychiatry and telepsychiatry are two ways to fill the shortages of psychiatric providers that exist in many areas in the United States. Employment and salary data in these areas can be used to illuminate current trends and anticipate future solutions to the problem of increasing demand for, and decreasing supply of, psychiatrists in the United States. A search was conducted of the literature and relevant Web sites, including PubMed, Google Scholar, and www.google.com , as well as information obtained from locum tenens and telepsychiatry organizations. There is a dearth of data on the use of locum tenens in the field of psychiatry, with little available prior to 2000 and few published studies since then. The majority of the data available are survey data from commercial entities. These data show trends toward increasing demand for psychiatry along with increasing salaries and indicate the utilization of telepsychiatry and locum tenens telepsychiatry is increasing. The published academic data that are available show that although locum tenens psychiatry is slightly inferior to routine psychiatric care, telepsychiatry is generally equivalent to face-to-face care. One can anticipate that as the national shortage of psychiatrists is expected to accelerate, use of both locum tenens and telepsychiatry may also continue to increase. Telepsychiatry offers several possible advantages, including lower cost, longer-term services, quality of care, and models that can extend psychiatric services. If current trends continue, systems that demand face-to-face psychiatry may find themselves paying higher fees for locum tenens psychiatrists, whereas others may employ psychiatrists more efficiently with telepsychiatry.
Practicing within the paradigm of compartmentalized specially treatment without a collaborative practice is ineffective for the chemical dependency and dual diagnosis population. Chemical dependency is not well understood as a disease, evidenced by barriers cited from the 2005 Survey on Drug Use and Health. Recovery from addiction and dual diagnosis logically demands an integrated and science-based treatment approach with unified standards for care and improved educational standards for preparation of care providers. Consultation and collaboration with addiction and psychiatric specialists is needed to establish consistency in standards for treatment and holistic care, essential for comorbidity. Continued learning and research about the complexity of the addiction process and comorbidity will provide continued accurate information about the harmful effects of alcoholism and drug abuse which in turn will empower individuals to make informed choices and result in better treatment and social policies.
Swan, Beth Ann; Haas, Sheila A; Chow, Marilyn
On March 1-2, 2010, a state-of-the-science invitational conference titled "Ambulatory Care Registered Nurse Performance Measurement" was held to focus on measuring quality at the RN provider level in ambulatory care. The conference was devoted to ambulatory care RN performance measurement and quality of health care. The specific emphasis was on formulating a research agenda and developing a strategy to study the testable components of the RN role related to care coordination and care transitions, improving patient outcomes, decreasing health care costs, and promoting sustainable system change. The objectives were achieved through presentations and discussion among expert inter-professional participants from nursing, public health, managed care, research, practice, and policy. Conference speakers identified priority areas for a unified practice, policy, and research agenda. Crucial elements of the strategic dialogue focused on issues and implications for nursing and inter-professional practice, quality, and pay-for-performance.
Burriss, F Antoinette; Breland-Noble, Alfiee M; Webster, Joe L; Soto, Jose A
Juvenile mental health courts for adjudicated youth. To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts. ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000-2010. Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation. © 2011 Wiley Periodicals, Inc.
van Dover, Leslie; Pfeiffer, Jane Bacon
This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.
Shri Gopal Goyal
Full Text Available Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psychiatric diagnosis of patients referred to C-L psychiatric services at a tertiary care center. Settings and Design: This was a descriptive cross-sectional study conducted in a tertiary care multispecialty teaching institution. Patients and Methods: The study population comprised all the patients who were referred for psychiatric consultation from other departments to C-L services of psychiatry department for 2 months. Information was collected using semi-structured pro forma, and diagnosis was made based on the International Classification of Diseases-10 criteria. Results: A total of 160 patients were referred for C-L psychiatric services. Majority of the patients were in the age group of 31–45 years, married, educated matriculation or beyond, belonged to Hindu religion, nuclear family, and residing in urban area. The maximum referrals were from internal medicine department (17.5 followed by nephrology (15.0% and neurology (10.6%. The most common psychiatric diagnosis was depression (12% followed by delirium (8%. The most common reason for seeking psychiatric consultation was psychiatric clearance of prospective kidney donor and bone marrow transplant/stem cell transplant recipient. Conclusions: Psychiatric comorbidity may present with chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric comorbidity.
... cases, you can also call the Department of Health. Nursing homes are required to post information on how you ... nursing homes in your area, go to Medicare’s Nursing Home Compare website at ... information is not intended to diagnose health problems or to take the place of medical ...
Koivunen, Marita; Anttila, Minna; Kuosmanen, Lauri; Katajisto, Jouko; Välimäki, Maritta
Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.
Yonge, O; Austin, W; Qiuping, P Z; Wacko, M; Wilson, S; Zaleski, J
The purpose of this study was to assess the quality of quantitative psychiatric/mental health nursing research articles published in English between 1982 and 1992, worldwide. Criteria for selection of articles included nurse authorship or co-authorship, use of a quantitative design and pertinence to an aspect of the nursing process with psychiatric/mental health patients. One hundred and ninety-four articles met these criteria. The quality of each article was assessed by two nurse experts using Duffy's Research Appraisal Checklist (RAC). Forty-six point nine per cent of the articles were rated as superior, 50% as average and 3.1% as below average. Other findings identified journals that published research articles, countries in which research was completed, applicability of funding and qualifications of the authors. The major implications of this study are that nurses can be directed to superior articles; more publication of research by nurse authors is warranted, research is being completed with little financial support, highly rated research publications tend to get funding and editorial policies affect the quality of publication.
Ali Zargham-Boroujeni; Jahangir Maghsoudi; Hamid Reza Oreyzi
Background: Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. M...
Vuokila-Oikkonen, P; Janhonen, S; Vaisanen, L
The cooperative team meeting is one of the most important interventions in psychiatric care. The purpose of this study was to describe the participation of patients and significant others in cooperative team meetings in terms of unspoken stories. The narrative approach focused on storytelling. The data consisted of videotaped cooperative team meetings (n = 11) in two acute closed psychiatric wards. The QRS NVivo computer program and the Holistic Content Reading method were used. During the process of analysis, the spoken and unspoken stories were analysed at the same time. According to the results, while there was some evident shared-rhythm cooperation (the topics of discussion were shared and the participants had eye contact), there were many instances where the interaction was controlled and defined by health care professionals. This lack of shared rhythm in cooperation, as defined in terms of storytelling, was manifested as monologue and the following practices: the health care professionals controlled the storytelling by sticking to their opinions, by giving the floor or by pointing with a finger and visually scanning the participants, by interrupting the speaker or by allowing the other experts to sit passively. Implications for mental health nursing practice are discussed.
Full Text Available This is a systematic compilation study which aimed to determine whether psychiatry nurses were fatigue of compassion, or not. The screening of several databases revealed four articles fulfilling inclusion criteria of the study. While three of the articles examined were descriptive; one was in cross-sectional pattern. Along the inclusion criterions, no any Turkish article was determined regarding the subject. In these articles, compassion fatigue concept has usually been considered with compassion satisfaction and burnout concepts. According to the findings of aforesaid articles, it was determined that compassion satisfaction of psychiatry nurses was at low level; that their compassion fatigue and burnout levels were high; and as well that they showed post-traumatic stress symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(4.000: 421-420
descriptive approach was chosen. The theoretical framework includes Jarvis’ concept of ‘disjuncture’, because it offers a theoretical way of understanding the empirical phenomenon of ‘non-routine-situations’. Heller’s concept of ‘everyday life activities’ is also drawn on, for its contribution......When the Danish government converted the national practice-oriented nursing qualification from a vocational course to a bachelor’s degree in 2002, the clinical training component was scaled back. Accordingly, mentors needed to optimise students’ learning from this curtailed clinical practice...... participant which takes place just after the researcher’s observation of the participant in interaction with a patient. The role of the researcher is to be a catalyst for the reflection. Using qualitative content analysis, a model of student nurses learning processes, termed the ‘Windmill of Learning...
Kotzer, Anne Marie; Koepping, Dianne M; LeDuc, Karen
Nurse job satisfaction is a complex phenomenon and includes elements of the work environment. The purpose of this study was to evaluate nurses' perception of their real (current) and ideal (preferred) work environment in a pediatric tertiary care setting. Using a descriptive survey design, a convenience sample of staff nurses from three inpatient units was surveyed using the Work Environment Scale (WES) by Moos (1994). The WES consists of 10 subscales characterizing three dimensions: Relationship, Personal Growth, and System Maintenance and Change. Overall, nurses affirmed a highly positive and supportive work environment on their units. Non-significant findings between the real and ideal scores for the Involvement and Managerial Control subscales suggest that staff are concerned about and committed to their work, and satisfied with their managers' use of rules and procedures. Statistically significant differences between selected real and ideal subscale scores will help target intervention strategies to enhance the nursing work environment.
Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. To describe the process of a team development project considering ward rule issues, and to develop a working model to empower staff in their daily in-patient psychiatric nursing practices. The design of this study is explorative and descriptive. Participatory action research methodology was applied to understand ward rules. Data consists of audio-recorded group discussions, observations and field notes, together creating a data set of 556 text pages. More than 100 specific ward rules were identified. In this process, the word rules was relinquished in favor of adopting the term principles, since rules are inconsistent with a caring ideology. A linguistic transition led to the development of a framework embracing the (1) Principle of Safety, (2) Principle of Structure and (3) Principle of Interplay. The principles were linked to normative guidelines and applied ethical theories: deontology, consequentialism and ethics of care. The work model reminded staff about the principles, empowered their professional decision-making, decreased collegial conflicts because of increased acceptance for individual decisions, and, in general, improved well-being at work. Furthermore, the work model also empowered staff to find support for their decisions based on principles that are grounded in the ethics of totality.
A patient's refusal of nursing care concerns the caregivers. Future professionals must be prepared for it and student nurses are trained to deal with such situations. It is also important to empower patients and support them in their choice. This article presents the example of the Haute École Robert Schuman in Libramont, Belgium. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Lydia V. Monareng
Full Text Available Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.
Hanrahan, Nancy P.; Wu, Evan; Kelly, Deena; Aiken, Linda H.; Blank, Michael B.
Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI) were randomly assigned to an intervention group (n=128) or to a control group (n=110). Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012) and the physical component of health-related quality of life (P=.03) from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population. PMID:21935499
Dorr, David A.; Tran, Hanh; Gorman, Paul; Wilcox, Adam B.
Unmet information needs of physicians and patients are common, but those of nurse care managers – defined as collaborative care planners for with chronic conditions – are less well understood. We taped and transcribed daily activities and conducted semi-structured interviews of 7 care managers, and analyzed questions elicited through this work through a variety of frameworks. PMID:17238532
Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de
BACKGROUND: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with
Piredda, Michela; Matarese, Maria; Mastroianni, Chiara; D'Angelo, Daniela; Hammer, Marilyn J; De Marinis, Maria Grazia
Care dependence can be associated with suffering and humiliation. Nurses' awareness of patients' perception of care dependence is crucial to enable them in helping the dependent persons. This study aimed to describe adult patients' experience of nursing care dependence. A metasynthesis was conducted to integrate qualitative findings from 18 studies published through December 2014 on adult patients' experiences of care dependency. Procedures included the Johanna Briggs Institute approach for data extraction, quality appraisal, and integration of findings. The experience of dependence revealed the concept of the embodied person, particularly in relation to care of the physical body. The relationship between the individual and nurses within the context of care had a major impact for dependent patients. When the care relation was perceived as positive, the experience led to the development of the person in finding new balances in life, but when it was perceived as negative, it increased patient' suffering. Care dependence is manifested mostly as bodily dependence and is consistent with its relational nature. The nurse-patient relationship is important to the dependent patients' experience. A greater understanding of patients' experiences of dependence is crucial to enable nurses in improving care and decreasing patient suffering. © 2015 Sigma Theta Tau International.
Ingrid Schivre's nursing practice in an emergency department has evolved towards more relaxing approaches which allow for a greater focus on the notion of caring. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.
Bilgin, Hülya; Buzlu, Sevim
In Turkey, the cultural structure effects the gender roles in the society, and women are subject to violence in an intense manner both inside the family and in their workplaces. In nursing, which is still defined as a woman's job in our country, it is possible to encounter many aggressive and threatening behaviours. Knowing no geographical borders, aggression leads to dissatisfaction and alienation with the profession for the nurses working at the psychiatric institutions in Turkey, thus aggression is a significant health risk in physical, psychological and social dimensions. The research was carried out with 162 randomly selected nurses working in the psychiatric institutions in Istanbul using the Attitudes Toward Patient Physical Assault Questionnaire. It has been determined that nurses' rate of exposure to verbal/physical assault by the patients and their relatives is high and that they experience an intense uncertainty and conflict, especially in legal issues, and that the duration of working in the psychiatry clinics effects attitudes toward the assaults. It is concluded that the nurses working at the psychiatry clinics in Turkey are under risk in regards to safety and they need protection and support, both in emotional and in legal terms.
Laís de Mello Santos
Full Text Available Abstract Objectives: To identify the strategies used by teachers to share the contents of Psychiatric Nursing and Mental Health; to describe the stages of knowledge sharing in light of the knowledge transfer process. Method: Qualitative, descriptive-exploratory research of the case study type, carried out with six teachers and 23 students, data production was by semi-structured interview and focus group. For the data analysis, the SECI knowledge conversion model was used: socialization, externalization, combination and internalization. Results: Teachers made socialization and externalization, but did not make clear the assessment and teaching-learning strategies. The combination was completed, but the internalization was unfinished, despite suggesting an attempt to reach it. Conclusion: The feasibility and applicability of the knowledge transfer process to the teaching of Psychiatric Nursing were confirmed.
Zhang, Aihua; Tao, Hong; Ellenbecker, Carol Hall; Liu, Xiaohong
To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China. Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown. A cross-sectional design was selected for this descriptive correlation study. Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010. Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job. Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse. © 2012 Blackwell Publishing Ltd.
Peng, Xiao; Liu, Yilan; Zeng, Qingsong
Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.
Mayron Morais Almeida
Full Text Available Introduction: The burden of care in family refers to the weight caused by the primary caregiver role to psychiatric patients and the difficulties encountered in performing this function in daily life. Objectives: Assessing the objective and subjective overload of family members who live with the reality of psychiatric disorder in a child day-care psychosocial care center. Methods: Cross-sectional study, descriptive-exploratory, of quantitative approach, with non-probabilistic samples of accidental type with 80 families of psychiatric patients held in a Psychosocial Care Center. For overload evaluation, the subscales "B" and "D" of the Family Overload Rating Scale (FBIS-BR were used. Results: The study was conducted with 80 families of psychiatric patients. The average age of female caregivers was 39,6 years old, and 40,7 years old for male caregivers, with female predominance (87,5% compared to men (12,5%, with low education for both genres. Family caregivers presented high objective burden due to excessive demand attention (p<0,001, heteroaggressiveness (p<0,001 and perplexing behavior of psychiatric patients regarding the supervision of problematic behaviors (p<0,001. The items on the impact on the family's daily routine have not helped to generate objective overload for the family members. On subjective overload, it was clear to observe familiar members with high degree of disturbance in all the dimensions assessed (p < 0,001. Conclusion: The high degree of care overload observed in family members indicates the need to develop contacts with the family of the psychiatric patient to answer questions, offer support and assistance to the family caregiver. Keywords: Caregivers. Patients. Mental Health Services.
de Vries, T W; Doddema, J W
A 15-year-old girl was admitted because of an abdominal tumour and inability to eat. History revealed that after an accident at 9 years of age she increasingly developed medically unexplained signs and symptoms (e.g. tunnel vision with blindness, paralysis and loss of sensitivity below the umbilicus, periods of diminished consciousness). No somatic explanation could be found; the parents rejected psychiatric examination. Upon physical examination the patient's weight's was far below the third percentile (32 kg) and the tumour appeared to be the lumbar spine, palpable through the abdominal wall. Following tube feeding and behavioural therapy the girl gained weight and the tumour disappeared. No cause for the underweight was found. Conversion disorder was diagnosed. However, the parents strongly refused to accept this diagnosis; they lodged complaints with various bodies and made further treatment and counseling impossible. Children with psychological problems who were treated as having a somatic disorder by their mothers have been described before. The outcome can be lethal. Children showing unexplained signs and symptoms whose parents strongly refuse psychiatric care will be seriously jeopardised in terms of their somatic and psychological development. Physicians should identify this situation at an early stage.
Tunlind, Adam; Granström, John; Engström, Åsa
Management of technical equipment, such as ventilators, infusion pumps, monitors and dialysis, makes health care in an intensive care setting more complex. Technology can be defined as items, machinery and equipment that are connected to knowledge and management to maximise efficiency. Technology is not only the equipment itself, but also the knowledge of how to use it and the ability to convert it into nursing care. The aim of this study is to describe critical care nurses' experience of performing nursing care in a high technology healthcare environment. Qualitative, personal interviews were conducted during 2012 with eight critical care nurses in the northern part of Sweden. Interview transcripts were analysed using qualitative content analysis. Three themes with six categories emerged. The technology was described as a security that could facilitate nursing care, but also one that could sometimes present obstacles. The importance of using the clinical gaze was highlighted. Nursing care in a high technological environment must be seen as multi-faceted when it comes to how it affects CCNs' experience. The advanced care conducted in an ICU could not function without high-tech equipment, nor could care operate without skilled interpersonal interaction and maintenance of basal nursing. That technology is seen as a major tool and simultaneously as a barrier to patient-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.
Salzmann-Erikson, Martin; Söderqvist, Cecilia
The aim of this study was to describe individuals' experiences of being hospitalized in psychiatric intensive care units (PICUs). Four participants who had previously been admitted in a PICU were interviewed using open-ended questions. The data were analyzed using thematic analysis. Analysis resulted in a synthesis of the various ways patients experienced limitations: (1) Descriptions of Being Limited in the Environment, (2) Descriptions of being Limited in Interactions with Staff, (3) Descriptions of Being Limited in terms of Access to Information, and (4) Descriptions of Having Limited Freedom and Autonomy. Hospitalization is experienced as a life-changing event that shows a kaleidoscopic view of limitation. We stress that the conceptualization of limitation must be considered due to its historical origins, sociopolitical aspirations, and philosophy of care. Thus, nurse practitioners and nursing leaders are advised to put the patient's experience at the center of care, and to involve and integrate patients throughout the recovery process.
Verpoort, Charlotte; Gastmans, Chris; Dierckx de Casterlé, Bernadette
In debates on euthanasia legalization in Belgium, the voices of nurses were scarcely heard. Yet studies have shown that nurses are involved in the caring process surrounding euthanasia. Consequently, they are in a position to offer valuable ideas about this problem. For this reason, the views of these nurses are important because of their palliative expertise and their daily confrontation with dying patients. The aim of this paper is to report a study of the views of palliative care nurses about euthanasia. A grounded theory approach was chosen, and interviews were carried out with a convenience sample of 12 palliative care nurses in Flanders (Belgium). The data were collected between December 2001 and April 2002. The majority of the nurses were not a priori for or against euthanasia, and their views were largely dependent on the situation. What counted was the degree of suffering and available palliative options. Depending on the situation, we noted both resistance and acceptance towards euthanasia. The underlying arguments for resistance included respect for life and belief in the capabilities of palliative care; arguments underlying acceptance included the quality of life and respect for patient autonomy. The nurses commented that working in palliative care had a considerable influence on one's opinion about euthanasia. In light of the worldwide debate on euthanasia, it is essential to know how nurses, who are confronted with terminally ill patients every day, think about it. Knowledge of these views can also contribute to a realistic and qualified view on euthanasia itself. This can be enlightening to the personal views of caregivers working in a diverse range of care settings.
These days, discussions of what might be the 'essence' or the 'core' of nursing and nursing practice sooner or later end in a discussion about the concept of care. Most of the 'newer' nursing theories use this concept as a theoretical core concept. Even though these theoretical approaches use the concept of care with very different philosophical foundations and theoretical consistency, they concur in defining care as the essence of nursing and thereby glorify goodness as the decisive characteristic of nursing. These theoretical approaches neglect the fact that nursing is above all a profession with a societal task and is characterized by an asymmetrical power relation between nurses and their patients. Based on the results of a research project that analysed the role nurses played in the killing of psychiatric patients in Germany during the Nazi regime, I demonstrate that an approach based on the concept of care is not able to explain how nurses were able to commit crimes of such atrocity. These crimes were bound to an emotional investment that sustained the production of 'life unworthy of living'. In the case of nurses under the Nazi regime, certainly a kind of sadism was at issue that can only be explained if we recognize that the social bond is characterized by a certain tension; 'goodness' that caring theories assign to the social bond always coexists with the capacity for destruction. Using the Foucauldian theoretical framework of biopower and biopolitics enables one to analyse violence and power as integral parts of nurses' practice. Seen from this perspective, the killing of patients was part of a biopolitical programme and not a relapse into barbarism. The concept of care obscures the political agenda of nursing and does not provide a critical and political framework to analysing nursing practice. © 2013 John Wiley & Sons Ltd.
McDonald, Katie; Rubarth, Lori Baas; Miers, Linda J
The purpose of this study was to describe the job satisfaction of neonatal intensive care unit (NICU) nurses in the Midwestern United States. The factors explored in job satisfaction were monetary compensation (pay), job stress, caring for patients in stressful situations, level of autonomy, organizational support, level of knowledge of the specialty, work environment, staffing levels, communication with physicians, communication with neonatal nurse practitioners, interdisciplinary communication, team spirit, and the amount of required "floating" to other nursing units. Participants were 109 NICU nurses working as either staff nurses (n = 72) or advanced practice nurses (n = 37). Of the participants, 96% worked in a level 3 NICU. A descriptive, correlational design was used to study job satisfaction among NICU nurses. Nurses were recruited at 2 regional NICU conferences in 2009 and 2010. The questionnaire was a researcher-developed survey consisting of 14 questions in a Likert-type response rating 1 to 5, with an area for comments. Descriptive statistics and correlations were used to analyze the resulting data. The majority of participants were moderately satisfied overall in their current position and workplace (mean ranking = 4.07 out of 5.0). Kendall's Tau b (TB) revealed that the strongest positive correlations were between organizational support and team spirit with overall job satisfaction (TB = 0.53). : The individual factors with the highest mean scores were caring for patients in a stressful situation, level of autonomy, and communication between nurses and neonatal nurse practitioners. This indicates that our population of NICU nurses feels most satisfied caring for patients in stressful situations (m = 4.48), are satisfied with their level of autonomy (M = 4.17), and are satisfied with the interdisciplinary communication in their units (m = 4.13). Nurses in the NICU are relatively satisfied with their jobs. The small sample size (n = 109) of Midwest NICU
Gurses, Ayse P; Carayon, Pascale
High nursing workload, poor patient safety, and poor nursing quality of working life (QWL) are major issues in intensive care units (ICUs). Characteristics of the ICU and performance obstacles may contribute to these issues. The goal of this study was to comprehensively identify the performance obstacles perceived by ICU nurses. We used a qualitative research design and conducted semi-structured interviews with 15 ICU nurses of a medical-surgical ICU. Based on this qualitative study and a previously reported quantitative study, we identified seven main types of performance obstacles experienced by ICU nurses. Obstacles related to the physical environment (e.g., noise, amount of space), family relations (e.g., distractions caused by family, lack of time to spend with family), and equipment (e.g., unavailability, misplacement) were the most frequently experienced performance obstacles. The qualitative interview data provided rich information regarding the factors contributing to the performance obstacles. Overall, ICU nurses experience a variety of performance obstacles in their work on a daily basis. Future research is needed to understand the impact of performance obstacles on nursing workload, nursing QWL, and quality and safety of care.
Thaís Helena Piai-Morais
Full Text Available OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69; adherence received (3.86 and obstacles (3.78, while intermediaries and the scales of organizational factors received low scores (2.61. There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000. The training scale for prevention of HIV exposure (p = 0.007 was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.
Miller, Donna M; Neelon, Lisa; Kish-Smith, Kathleen; Whitney, Laura; Burant, Christopher J
The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. Postintervention descriptive study. The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States. Critical care RNs were asked to participate in this project over a 3-week period following a multimodal 2-year education initiative. Nurses completed the paper version of the 72-item Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) to determine pressure injury knowledge level. Calculated mean cumulative scores and subscores for items related to prevention and staging, respectively. Pearson correlations were used to examine associations between nursing staff characteristics and the PZ-PUKT prevention and staging scores. The cumulative score on the PZ-PUKT was 51.66 (72%); nurses with 5 to 10 years' experience had a higher mean score than nurses with experiences of 20 years or more (mean ± SD = 54.25 ± 4.37 vs 49.5 ± 7.12), but the difference was not statistically significant. Nurses scored higher on the staging system-related items as compared to the prevention-related items (81% vs 70%). Nurses achieved higher staging subscale scores if they were younger (r =-0.41, P < .05), had less experience (r =-0.43, P < .05), and if they worked in the medical intensive care unit (r = 0.37, P < .05). Study findings indicate gaps in knowledge related to pressure injury practice; participants had greater knowledge of staging rather than prevention. Cumulative and subscale findings can be used to direct educational efforts needed to improve and maintain an effective pressure injury prevention program.
Widger, Kimberley; Pye, Christine; Cranley, Lisa; Wilson-Keates, Barbara; Squires, Mae; Tourangeau, Ann
Generational differences in values, expectations and perceptions of work have been proposed as one basis for problems and solutions in recruitment and retention of nurses. This study used a descriptive design. A sample of 8207 registered nurses and registered practical nurses working in Ontario, Canada, acute care hospitals who responded to the Ontario Nurse Survey in 2003 were included in this study. Respondents were categorized as Baby Boomers, Generation X or Generation Y based on their birth year. Differences in responses among these three generations to questions about their own characteristics, employment circumstances, work environment and responses to the work environment were explored. There were statistically significant differences among the generations. Baby Boomers primarily worked full-time day shifts. Gen Y tended to be employed in teaching hospitals; Boomers worked more commonly in community hospitals. Baby Boomers were generally more satisfied with their jobs than Gen X or Gen Y nurses. Gen Y had the largest proportion of nurses with high levels of burnout in the areas of emotional exhaustion and depersonalization. Baby Boomers had the largest proportion of nurses with low levels of burnout. Nurse managers may be able to capitalize on differences in generational values and needs in designing appropriate interventions to enhance recruitment and retention of nurses.
Tait, Glendon R.; Hodges, Brian D.
Objective: The authors examined psychiatric residents' attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. Methods: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey…
The article demonstrates that over a period of many years the development of national psychiatric care in Russia followed the course of centralization. During the Zemstvo self government period the principle of decentralization was proposed on purpose to make the psychiatric care more accessible for population.
De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Moons, Philip
Are home nurses (also known as community nurses) ready for their changing role in primary care? A quantitative study was performed in home nursing in Flanders, Belgium, to explore the activity profile of home nurses and health care assistants, using the 24-hour recall instrument for home nursing. Seven dates were determined, covering each day of the week and the weekend, on which data collection would take place. All the home nurses and health care assistants from the participating organisations across Flanders were invited to participate in the study. All data were measured at nominal level. A total of 2478 home nurses and 277 health care assistants registered 336 128 (47 977 patients) and 36 905 (4558 patients) activities, respectively. Home nurses and health care assistants mainly perform 'self-care facilitation' activities in combination with 'psychosocial care' activities. Health care assistants also support home nurses in the 'selfcare facilitation' of patients who do not have a specific nursing indication.
du Plessis, E
To report on an appreciation of caring presence practised by nurses in South Africa in order to facilitate an appreciative discourse in nursing and a return to caring values and attitudes. Appreciative reports on caring presence are often overlooked. Media may provide a platform for facilitating appreciation for caring presence practised by nurses. Such an appreciation may foster further practice of caring presence and re-ignite a caring ethos in nursing. This article provides an appreciative discourse on caring presence in nursing in the form of examples of caring presence practised by nurses. An anecdotal approach was followed. Social media, namely narratives on caring presence shared by nurses on a Facebook page, and formal media, namely news reports in which nurses are appreciated for their efforts, were used. Deductive content analysis was applied to analyse the narratives and news reports in relation to a definition of caring presence and types of caring presence. The analysis of the narratives and news reports resulted in an appreciative discourse in which examples of nurses practising caring presence could be provided. Examples of nurses practising caring presence could be found, and an appreciative discourse could be initiated. Appreciation ignites positive action and ownership of high-quality health care. Leadership should thus cultivate a culture of appreciating nurses, through using media, and encourage nurses to share how caring presence impact on quality in health care. © 2016 International Council of Nurses.
Imai, Hirohisa; Nakao, Hiroyuki; Nakagi, Yoshihiko; Niwata, Satoko; Sugioka, Yoshihiko; Itoh, Toshihiro; Yoshida, Takahiko
The Community Health Act came into effect in 1997 in Japan. This act altered the work system for public health nurses (PHNs) in public health centers (PHCs) nationwide from region-specific to service-specific work. Such major changes to working environment in the new system seem to be exposing PHNs to various types of stress. The present study examined whether prevalence of burnout is higher among PHNs in charge of mental health services (psychiatric PHNs) than among PHNs in charge of other services (non-psychiatric PHNs), and whether attributes of emergency mental health care systems in communities are associated with increased prevalence of burnout. A questionnaire including the Pines burnout scale for measuring burnout was mailed to 525 psychiatric PHNs and 525 non-psychiatric PHNs. The 785 respondents included in the final analysis comprised 396 psychiatric PHNs and 389 non-psychiatric PHNs. Prevalence of burnout was significantly higher for psychiatric PHNs (59.2%) than for non-psychiatric PHNs (51.5%). When prevalence of burnout in each group was analyzed in relation to question responses regarding emergency service and patient referral systems, prevalence of burnout for psychiatric PHNs displayed significant correlations to frequency of cases requiring overtime emergency services, difficulties referring patients, and a feeling of "restriction". Prevalence of burnout is high among psychiatric PHNs, and inadequate emergency mental health service systems contribute to burnout among these nurses. Countermeasures for preventing such burnout should be taken as soon as possible.
Team work is required in the treatment of the thermally injured patient--nursing staff being part of the team. The nurses are with the patient for 24 hours a day and they have to understand the objectives of all other members of the team involved in the treatment as well as thoroughly mastering their own work. For the nursing staff the care of the thermally injured patient is a challenge. The work demands strong motivation and interest--it includes at times painful treatment, isolation and also constant alertness. It is important that the nursing staff is given continuous training so that they are able to give the required care efficiently and to keep up active interest. Practical work is the best way of getting aquainted with the complex forms of treatment of the thermally injured patient. It also lessens the fear of a badly burned patient. Nursing care of the thermally injured patient consists of good basic care, local attention and active observation. The basic care consists of basic hygiene, diet, observation of the patient's psychological condition, giving emotional support, encouraging initiative physiotherapy and postural treatment.
Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline
To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.
Lincoln, C V; McGorry, P
The authors reviewed the literature to better understand pathways to psychiatric care among young persons experiencing a first episode of psychosis. Because no discrete body of literature exists about how young people with psychotic illness gain access to psychiatric services, the authors examined three related areas: illness recognition, help-seeking, and referral pathways. Automated and manual searches of primarily medical and psychological sources from 1977 to 1995 were conducted. The review found evidence of delay in obtaining early treatment among young people with an emerging psychosis, although comparisons between studies are difficult. Early psychiatric intervention is believed to significantly aid recovery and is an increasingly important clinical issue. Recognizing psychiatric illness is problematic for professionals and nonprofessionals. Understanding of help seeking by patients experiencing a first psychotic episode and of their referral pathways is limited. Taken together, studies suggest factors affecting access to treatment but provide neither sufficient empirical information nor an adequate conceptual framework to better target secondary prevention strategies. Formulation of a pathways-to-care model appears to offer a useful way of understanding mental health care use. Exploration of consumer experiences would enrich the model. Strategies to reduce treatment delay could then be developed and evaluated. Increased consumer involvement might help ensure that services are better tailored to patients' needs.
Maintaining continence lies at the heart of a sense of adulthood and is essential to preserving dignity, a core and universal nursing value. This article explores the reasons why poor continence care was found at Mid Staffordshire Foundation Trust, the changes to the culture of the health service that led to it, and why it is so important for nurses to maintain patients' dignity. Recommendations for changing this culture in the future are discussed.
Schmitz, Eudinéia Luz; Gelbcke, Francine Lima; Bruggmann, Mario Sérgio; Luz, Susian Cássia Liz
To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.
Ganzer, Christine Anne; Zauderer, Cheryl
The purpose of this qualitative study was to test a teaching-learning strategy to help nursing students decrease stress and anxiety that may be brought about by the psychiatric mental health clinical experience. Undergraduate nursing students are known to experience affective stress prior to their first psychiatric mental health clinical practicum. A stressful learning environment can affect the success of the student's clinical performance. Thirty nursing students participated in this study. A structured preclinical workshop combined with self-reflection provided insight into students' perceptions of the psychiatric mental health clinical experience. Overall, students reported that participating in the teaching-learning strategy and self-reflection helped mitigate Combining structured learning with self-reflection is a useful tool for helping nursing students increase self-awareness and ease anxiety that may interfere with learning.
ÖZCANLI, Derya; İLGÜN, Seda
Time is not like other resources, because it can not be bought, sold, stolen, borrowed, stored, saved, multiplied or changed. All it can be done is spent. Time management means the effective use of resources, including time, in such a way that indi- viduals are effective in achieving important personal goals. With the increasing emphasis on efficiency in health care, how a nurse manages her time is an important consideration. Since intensive care nurs- ing is focused on the care and tr...
Strandås, Maria; Fredriksen, Sven-Tore D
Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data. Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. © The Author(s) 2014.
Care means taking care, paying extreme attention to others in vulnerable situations, "helping and not hurting". Admitting that ethical care exists would require recognizing that there are also treatments which are not ethical. However, care can only be ethical. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Roberta Juliane Tono de Oliveira; Patrícia Madalena Vieira Hermida; Fernanda Hannah da Silva Copelli; José Luís Guedes dos Santos; Alacoque Lorenzini Erdmann; Selma Regina de Andrade
Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency se...
Murphy, Lyn S; Walker, Mark S
Healthcare today is challenged to provide care that goes beyond the medical model of meeting physical needs. Despite a strong historical foundation in spiritual whole person care, nurses struggle with holistic caring. We propose that for the Christian nurse, holistic nursing can be described as Spirit-guided care--removing oneself as the moiatiating force and allowing Christ, in the furm of the Holy Spirit, to flow through and guide the nurse in care of patients and families.
Srulovici, Einav; Drach-Zahavy, Anat
Missed nursing care is considered an act of omission with potentially detrimental consequences for patients, nurses, and organizations. Although the theoretical conceptualization of missed nursing care specifies nurses' values, attitudes, and perceptions of their work environment as its core antecedents, empirical studies have mainly focused on nurses' socio-demographic and professional attributes. Furthermore, assessment of missed nursing care has been mainly based on same-source methods. This study aimed to test the joint effects of personal and ward accountability on missed nursing care, by using both focal (the nurse whose missed nursing care is examined) and incoming (the nurse responsible for the same patients at the subsequent shift) nurses' assessments of missed nursing care. A cross-sectional design, where nurses were nested in wards. A total of 172 focal and 123 incoming nurses from 32 nursing wards in eight hospitals. Missed nursing care was assessed with the 22-item MISSCARE survey using two sources: focal and incoming nurses. Personal and ward accountability were assessed by the focal nurse with two 19-item scales. Nurses' socio-demographics and ward and shift characteristics were also collected. Mixed linear models were used as the analysis strategy. Focal and incoming nurses reported occasional missed nursing care of the focal nurse (Mean=1.87, SD=0.71 and Mean=2.09, SD=0.84, respectively; r=0.55, ppersonal socio-demographic characteristics, higher personal accountability was significantly associated with decreased missed care (β=-0.29, p0.05). The interaction effect was significant (β=-0.31, ppersonal accountability and missed nursing care. Similar patterns were obtained for the incoming nurses' assessment of focal nurse's missed care. Use of focal and incoming nurses' missed nursing care assessments limited the common source bias and strengthened our findings. Personal and ward accountability are significant values, which are associated with
Full Text Available Introduction. The TISS-28 scale, which may be used for nursing staff scheduling in ICU, does not reflect the complete scope of nursing resulting from varied cultural and organizational conditions of individual systems of health care. Aim. The objective of the study was an attempt to provide an answer to the question what scope of nursing care provided by Polish nurses in ICU does the TISS-28 scale reflect? Material and Methods. The methods of working time measurement were used in the study. For the needs of the study, 252 hours of continuous observation (day-long observation and 3.697 time-schedule measurements were carried out. Results. The total nursing time was 4125.79 min. (68.76 hours, that is, 60.15% of the total working time of Polish nurses during the period analyzed. Based on the median test, the difference was observed on the level of χ2=16945.8, P<0.001 between the nurses’ workload resulting from performance of activities qualified into the TISS-28 scale and load resulting from performance of interventions within the scopes of care not considered in this scale in Polish ICUs. Conclusions. The original version of the TISS-28 scale does not fully reflect the workload among Polish nurses employed in ICUs.
To apply Habermas' (1995) Theory of Moral Consciousness and Communicative Action to the nurse-patient relationship, offering a different interpretation to the nurse-patient relationship that is caring in nursing. Many authors have described the nurse-patient relationship, but Habermas' theory synthesizes the components into a complex matrix that is caring in nursing. The theory offers three claims to normative validity: the claim to truth which is the factual objective knowledge; the claim to truthfulness which refers to the intrasubjective self; and the claim to right which is the intersubjective interaction. The validity claims explain the patient's personal and illness self, the nurse's personal and professional self, and the interaction/discourse. The interaction is situation specific, and is identified as moral because dialogue/discourse requires a 'considerateness' of each for the other. 'Considerateness' in discourse requires certain rules, including that each participant has an equal voice, be followed in order for the Principle of Universalization to occur. Habermas draws on Kohlberg's (1981), and Selman's (1980) work to develop three levels of moral maturity of communication. These are preconventional, conventional, and postconventional. Initial moral maturity is egocentric, subjective, and obedient to authority. Maturity develops with recognition of other and reciprocity. At the postconventional level there is mutuality and the ability for abstract reasoning. There is a third person objectivity combining speaker and addressee/listener perspectives. Norms are not just accepted, they are reasoned through. This leads to justification of the norm, which is then accepted as valid. When the three validity claims are met and there is genuine 'considerateness' in the interaction there is communicative action. The reverse is strategic action, where the communication is coercive. When there is communicative action both patient and nurse are validated with a sense
Yadav, B L
Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.
Gonge, Henrik; Buus, Niels
The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample was 136 nursing staff members in permanent employment on nine general psychiatric wards and at four community mental health centres at a Danish psychiatric university hospital. Data were collected by means of a set of questionnaires. Participation in clinical supervision was associated with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses indicated that certain individual and workplace factors were related to subscales of the MCSS, as well as some of the benefits. The study supported the suggested model, but methodological limitations apply. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
Rezaei, Omid; Habibi, Kamelia; Arab Ghahestany, Davood; Sayadnasiri, Mohammad; Armoon, Bahram; Khan, Vida; Fattah Moghadam, Ladan
Background One of the most prevalent problems in work places that is considered as an important risk factor for the health of the employee is job burnout (JB). JB could be harmful to employees, their families and society. Therefore, decreasing JB among individuals and determining factors associated with it is important to improve the working environment and prevent its negative outcomes. This study aims to elicit the conditions and factors that cause job burnout among nurses of the Razi Psychiatric Hospital, Iran. Methods This study was a descriptive correlational and cross-sectional survey which the demographic and occupational burnout variables of nurses were measured. The study was conducted from January to April 2016. Accordingly, with a type I error probability of 0.05 and a power of 0.80, the sample size was determined to be 100 nurses for each group (men and women). Then, 200 were selected in the Razi Psychiatric Hospital (of whom approx. 60% worked in a rotating shift schedule). The data were collected in two phases: the first step was created by the authors, including gathering demographic data with questionnaire such as gender, age, marital status, education level, years of professional experience, hours of overtime working per month, shift schedules, and their working hospitals and wards. The second step was the Maslach burnout inventory (MBI), human services survey (HSS) version, developed by Maslach and Jackson to assess the three dimensions of burnout. Descriptive statistics (frequency distribution) were used for integrating the demographic variables. Additionally, logistical regression was applied to realize the association between demographic characteristics with the job burnout in SPSS software V.19. Results Our findings indicated that age, hours of work per week, nursing skills, management experience and work experiences accounted for 30% of the variance of depersonalization. Formal employment was significantly associated with emotional exhaustion
Fairbrother, Greg; Chiarella, Mary; Braithwaite, Jeffrey
This paper provides an overview of the developmental history of models of care (MOC) in nursing since Florence Nightingale introduced nurse training programs in a drive to make nursing a discipline-based career option. The four principal choices of models of nursing care delivery (primary nursing, individual patient allocation, team nursing and functional nursing) are outlined and discussed, and recent MOC literature reviewed. The paper suggests that, given the ways work is being rapidly reconfigured in healthcare services and the pressures on the nursing workforce projected into the future, team nursing seems to offer the best solutions.
Nielsen, Ben; Martinsen, Bente
to improve quality of life after being diagnosed with HIV, a sharp distinction between HIV and AIDS and a religious and spiritually coping. Identifying the emotional challenges women living with HIV face in their daily lives may help nurses obtain a clearer understanding and greater knowledge of how...... to provide HIV-positive women with effective care that empower and support these women in managing their chronic disease. However to ensure that nurses have the proper tools for effective care for women living with HIV European studies are essentials in relation to what emotional challenges these women...
Dick, Tracey K; Patrician, Patricia A; Loan, Lori A
To report an analysis of the concept of value of nursing care. Value-based health care delivery and reimbursement models are focused on value as a product of quality and cost. Nursing care provides tangible and intangible contributions to patient and organizational outcomes. The nursing profession must be able to proactively and effectively communicate the value of nursing care. Concept analysis. Thirty-five separate sources were chosen from database searches of CINAHL Complete and ABI/INFORM Complete. Key terms utilized for the search were "nursing value" OR "nursing care value" OR "value of nursing". Caron and Bowers' (2000) dimensional analysis method was used as a guide for the project. Dimensions identified from this concept analysis included: (a) economic, (b) relational, and (c) societal. Direct care nurses experience the relational and societal dimensions of the value of nursing care. Patients and/or families experience the relational dimension of value in nursing care. Health care administrators, third-party payers, and nurse researchers interpret value from the economic dimension. Future nursing research should better quantify the economic value of nursing care. Qualitative research which focuses on how patients and families experience the value of nursing care would also contribute to further refinement of this concept. © 2017 Wiley Periodicals, Inc.
Holikatti, Prabhakar C; Kar, Nilamadhab
It is common knowledge that patients seek treatment for psychiatric illnesses from various sources including the alternative medicine. Views and attitudes of clinicians often influence the provision of appropriate mental health care for these patients. In this context, it was intended to study the views of the practitioners of alternative medicine toward psychiatric disorders, patients and interventions. The study was conducted as a questionnaire-based survey among a sample of practitioners of alternative medicine specifically Ayurveda and Homeopathy, who were practicing in Solapur and adjoining areas of Maharashtra and Karnataka states in India. A semi-structured Attitudinal Inventory for Psychiatry questionnaire was used. Demographic and professional data were collected. Out of 62 practitioners approached, 50 responded (80.6%). There were no significant differences in the views of practitioners toward psychiatry and psychiatrists based on respondents' gender, place of residence, location of practice, type of alternative medicine, exposure to psychiatric patients, or if they knew someone with psychiatric illness. Attitudes were generally positive, but variable. Among negative observations were that approximately 60% of respondents felt that a patient can be disadvantaged by being given a psychiatric label and 58% believed that emotions are difficult to handle. A considerable proportion (40%) of the respondents felt doctors other than psychiatrists were unable to identify psychiatric disorders. This study's findings suggest that practitioners of alternative medicine have mixed views about mental illness, patients and treatment. Some of their negative views and perceived inability to identify psychiatric disorders may be addressed through further training, information sharing and collaborative work.
Silveira, Natyele Rippel; Nascimento, Eliane Regina Pereira do; Rosa, Luciana Martins da; Jung, Walnice; Martins, Sabrina Regina; Fontes, Moisés Dos Santos
to know the feelings of nurses regarding palliative care in adult intensive care units. qualitative study, which adopted the theoretical framework of Social Representations, carried out with 30 nurses of the state of Santa Catarina included by Snowball sampling. Data were collected through semi-structured interviews conducted from April to August 2015, organized and analyzed through the Collective Subject Discourse. the results showed how central ideas are related to feelings of comfort, frustration, insecurity and anguish, in addition to the feeling that the professional training and performance are focused on the cure. the social representations of nurses regarding the feelings related to palliative care are represented mainly by negative feelings, probably as consequence of the context in which care is provided.
Saqer, Tahani J; AbuAlRub, Raeda F
To (i) identify the types and reasons for missed nursing care among Jordanian hospital nurses; (ii) identify predictors of missed nursing care based on study variables; and (iii) examine the relationship between nurses' confidence in delegation and missed nursing care. Missed nursing care is a global concern for nurses and nurse administrators. Investigating the relation between the confidence in delegation and missed nursing care might help in designing strategies that enable nurses to minimise missed care and enhance quality of services. A correlational research design was used for this study. A convenience sample of 362 hospital nurses completed the missed nursing care survey, and confidence and intent to delegate scale. The results of the study revealed that ambulating and feeding patients on time, doing mouth care and attending interdisciplinary care conferences were the most frequent types of missed care. The mean score for missed nursing care was (2.78) on a scale from 1-5. The most prevalent reasons for missed care were "labour resources, followed by material resources, and then communication". Around 45% of the variation in the perceived level of "missed nursing care" was explained by background variables and perceived reasons for missed nursing. However, the relationship between confidence in delegation and missed care was insignificant. The results of this study add to the body of international literature on most prevalent types and reasons for missed nursing care in a different cultural context. Highlighting most prevalent reasons for missed nursing care could help nurse administrators in designing responsive strategies to eliminate or reduces such reasons. © 2018 John Wiley & Sons Ltd.
Tangu, KeumbÔh; Ifeanyi, Adaora; Velusamy, Mayurapriya; Dar, Sara; Shah, Nurun; Ezeobele, Ifeoma E; Okusaga, Olaoluwa O
The authors compared the current knowledge and attitude of psychiatrists, psychiatry residents, and psychiatric nurses towards the pharmacological management of acute agitation. Questionnaires were electronically distributed to all attending psychiatrists, psychiatry residents, and psychiatric nurses who were either employed by the University Department of Psychiatry and Behavioral Sciences or were staff at a 250-bed affiliated Psychiatric Hospital. Where possible, Fisher's exact test was used to compare responses to questions based on designation. Of the 250 questionnaires distributed, 112 were returned (response rate of 44.8%), of which 64 (57.1%) were psychiatric nurses, 27 (24.1%) were attending psychiatrists, and 21 (18.8%) were psychiatry residents. A significantly higher percentage of attending psychiatrists and psychiatric nurses compared to psychiatry residents thought that newer second- generation antipsychotics (SGAs) are not as effective as older first-generation antipsychotics (FGAs) for managing acute agitation (55.6, 48.4, and 9.5% respectively, p = 0.008). The combination of intramuscular haloperidol, lorazepam, and diphenhydramine was the most preferred option chosen by all designations for the psychopharmacological management of severe agitation. Furthermore, a larger percentage of the psychiatric nurses, in comparison to attending psychiatrists, also chose the combination of intramuscular chlorpromazine, lorazepam, and diphenhydramine as an option for managing severe agitation; no psychiatry resident chose this option. Knowledge of evidence-based psychopharmacological management of agitation differs among attending psychiatrists, psychiatry residents and psychiatric nurses. Although the management of agitation should be individualized and context specific, monotherapy should be considered first where applicable.
Accordini, M; Saita, E; Irtelli, F; Buratti, M; Savuto, G
WHAT IS KNOWN ON THE SUBJECT?: There is a growing emphasis on communication as a result of the move towards the more inclusive approach associated with the community-based rehabilitation model. Therefore, more importance is attached to handovers. Besides ensuring transfer of information, handovers enhance group cohesion, socialize staff members to the practices of the service and capture its organizational culture. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: While handovers are mainly used for information transfer and to manage the services' daily routine, this paper offers an insight on how handovers can be conceived as valuable instruments to document cultural and organizational change. Only a limited amount of studies has focused on handovers in mental healthcare settings, and most of them only consider the perspectives of psychiatric nurses, while embracing a broader perspective, this paper provides valuable insights into the perspectives of various service providers. The overcoming of the dichotomy deficit-based vs. recovery-oriented model is possible if professionals use handovers to reflect upon their practice and the ways in which their cultural models are affected by the environmental context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Handovers are valuable instruments to document organizational change. It would be important for psychiatric and rehabilitation facilities to keep track of the handover records over time as they may provide insightful information about cultural change and the transformations in the core values and beliefs held by professionals. Handovers assure a timely and correct information transfer while socializing workers to the service's culture; however, no study describes them as instruments to document organizational change and only a few have focused on psychiatric settings. Aim To investigate the change in the culture of an Italian psychiatric residential care home as perceived by its mental health workers (MHWs) over the course of
Full Text Available Introduction: Penitentiary Nursing has experienced during the last decades a deep transformation similar to that experienced by the rest of the Nursing. However, there is a great distance from the protective legislation. Objective: To analyze the main legal documents which regulate the functions of Penitentiary Nursing and to compare it with the health care reality of nurses in Spanish prisons. Methodology: Narrative bibliographic review based on various sources such as Medline, Cuiden, Scielo, Dialnet, etc. Results: Is selected 43 documents, due to its relevance with the theme object of study. Is rejected 4 articles for lack of the same. Analyzed documents regarding legal framework and functions of nursing in prisons in its different sections (health care, teaching, research and management. Conclusion: The functions currently carried out in prisons are the ones provided for by health care legislation outside the prison context, along with the internal administrative regulations established by prisons. The possibility should be reconsidered of integrating Prison Healthcare into the Public Healthcare System so as to guarantee equality of healthcare for persons deprived of liberty and to provide the same rights and obligations to health professionals working in this sector.
Penitentiary Nursing has experienced during the last decades a deep transformation similar to that experienced by the rest of the Nursing. However, there is a great distance from the protective legislation. To analyze the main legal documents which regulate the functions of Penitentiary Nursing and to compare it with the health care reality of nurses in Spanish prisons. Narrative bibliographic review based on various sources such as Medline, Cuiden, Scielo, Dialnet, etc. Is selected 43 documents, due to its relevance with the theme object of study. Is rejected 4 articles for lack of the same. Analyzed documents regarding legal framework and functions of nursing in prisons in its different sections (health care, teaching, research and management). The functions currently carried out in prisons are the ones provided for by health care legislation outside the prison context, along with the internal administrative regulations established by prisons. The possibility should be reconsidered of integrating Prison Healthcare into the Public Healthcare System so as to guarantee equality of healthcare for persons deprived of liberty and to provide the same rights and obligations to health professionals working in this sector.
Bowen, Matt; Mason, Tom
To understand better the skills and competencies for forensic and non-forensic nursing of psychopathic and personality disordered patients. In the UK, there has been growing interest in service provision for this client group, but with little research to support the nursing skills required. A non-experimental design, using a postal survey to 990 forensic and 500 non-forensic nurses. An information gathering schedule was used to generate data about the most desirable skills and competencies and least desirable weaknesses and nursing attributes to nurse this group. The results for the forensic nurses. Main strengths and skills: being firm, setting limits and defining boundaries. Main weaknesses: inability to engage, inability to resolve conflict and impatience. Main skills and competencies: being non-threatening, non-judgemental and able to expect anything. Least desirable qualities: over-reacting, being judgemental and over-confrontational. The results for the non-forensic nurses. Main strengths and skills: being non-judgemental, listening skills and good risk assessment. Main weaknesses: frustration with the system, a fear of aggression and no skills to engage. Main skills and competencies: being open-minded, non-judgemental and forming relationships. Least desirable qualities: a supercilious attitude, cynicism and being judgemental. The results highlight the importance of forming therapeutic relationships as the bedrock of both forensic and non-forensic nursing, and they also highlight the important differences with regard to the significance of therapeutic action and therapeutic verbal interaction. The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills
Holmes, Colin A; McAllister, Margaret; Crowther, Andrew
Nurses actively killed people in Nazi Europe between 1939 and 1945. The so-called ‘science of eugenics’ underpinned Nazi ideology, used to further the Nazi racist agenda. Edicts sanctioned selection and medically supervised killing of people, and nurses, principally in mental hospitals, participated in the killing of between 100–300 thousand patients. Erroneously termed ‘euthanasia', there were three phases: the initial programme involving children, the T4 adult programme, and ‘wild euthanasia'. Unofficial killings also took place before 1939. This paper uses discourse analysis to map and analyse published texts which explore the role of nurses in Nazi Germany. The aim is to identify its characteristics as a body of literature, to note strengths and weaknesses, emphases and silences, and to note aspects that need further exploration. It acknowledges that how these events are to be understood and represented in contemporary discourse constitutes a significant problem for historians of nursing.
Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.
Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive
Tjoflåt, Ingrid; Karlsen, Bjørg; Saetre Hansen, Britt
To describe how Norwegian expatriate nurses engaged in humanitarian assignments overseas experience working with the local nurses promoting nursing care in the hospital ward. Western countries have a long tradition of providing nurses with expert knowledge in nursing care for humanitarian projects and international work overseas. Studies from humanitarian mission revealed that health workers rarely acknowledge or use the local knowledge. However, there is a lack of studies highlighting expatriate nurses' experiences working with local nurses to promote nursing care in the hospital ward. This study applies a descriptive explorative qualitative design. The data were collected in 2013 by means of seven semi-structured interviews and analysed using qualitative content analysis. The data analyses revealed three themes related to the expatriate nurses' experiences of working with the local nurses to promote nursing care in the hospital ward: (1) Breaking the code, (2) Colliding worlds and (3) Challenges in sharing knowledge. The findings reflect different challenges when working with the local nurses. Findings indicate valuable knowledge gained about local nursing care and the local health and educational system. They also demonstrate challenges for the expatriate nurses related to the local nursing standard in the wards and using the local nurses' experiences and knowledge when working together. The findings can inform nurses, humanitarian organisations and institutions working overseas regarding the recruitment and the preparation of nurses who want to work cross- culturally or in humanitarian missions overseas. © 2016 John Wiley & Sons Ltd.
Albert Lengruber de Azevedo
Full Text Available Abstract Qualitative exploratory and descriptive study with the aim of analyzing the communication of nursing students in the listening to patients in mental suffering admitted in a psychiatric hospital. The study was carried out from April to May 2013, with 23 nursing students regularly enrolled in a public higher education institution in the Southeast of Brazil. The data were collected based on artistic production and interviews, analyzed and categorized according to their thematic content. Proxemic nonverbal communication was unanimously indicated by the students based on personal-body position of face, neck, and, shoulders adopted in the listening to patients in mental suffering. The conscious use of proxemics favored clinical reasoning, improving interaction and listening in speech and thought disorders. Attentive, effective, and affective listening demands availability, control of fear, tension, anxiety, and insecurity.
Main goal of the thesis was to map out the specifics of nursing care for a patient with a nutritious stoma. Three research questions have been identified in connection to this goal. First research question was focused on mapping out the nursing care for a patient prior applying the nutritious stoma. Second research question was focusing on nursing care for a patient while the nutritious stoma is being applied, and the last third question researches the nursing care for a patient after applyin...
Haberfellner, Egon Michael; Grausgruber, Alfred; Grausgruber-Berner, Rosemarie; Ortmair, Margarethe; Schöny, Werner
The study was intended to evaluate the therapeutic and healthcare services utilized by 116 former long-stay patients after an average of 42.9 months of deinstitutionalization during a follow-up time of (1/2) year and to calculate the costs thus incurred. 116 patients and their caregivers were interviewed during a period of 6 months using the German version of the Client Sociodemographic and Service Receipt Inventory. On average, 3.3 institutions/facilities were contacted per patient, most often by younger patients living in group homes and least often by patients in psychiatric nursing homes. During the 6-month follow-up time costs of euro 14,665 were incurred per patient. Of these costs, 87.2 % were for the residential facilities. The costs of outpatient care accounted for 41.4 % of the costs that would have been incurred for inpatient care in a psychiatric hospital. Deinstitutionalization of psychiatric long-stay patients in Upper Austria provided for considerable reductions in costs while maintaining a high quality of care.
Nurses in neurosurgical departments play a critical role as they are involved in the first stages of the care pathway of patients with glioblastoma. Indeed, surgery enables a definitive histopathological diagnosis to be established and the size of the tumour to be significantly reduced, thereby improving the prognosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Veenstra, Petra; Kollen, Boudewijn J.; de Jong, Gosse; Baarveld, Frans; van den Berg, J. S. Peter
Introduction Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve
Zeltzer, Barry B; Kohn, Robert
This study examined the practices of home care agencies and home health nursing agencies in the management and treatment of homebound clients with behavioral problems, dementia, and undiagnosed mental illnesses. A survey was mailed to all 54 directors of agencies in Rhode Island in 2003; 53 responded, either by mail or telephone. Data indicated a lack of psychiatric services, a reluctance to address behavioral problems, and a failure to identify undiagnosed disorders. There was also a bias against accepting individuals with primary psychiatric disorders. Although the population of homebound elders with mental illness is increasing, their needs are not being met by these agencies.
Liu, L; Coenen, A; Tao, H; Jansen, K R; Jiang, A L
This study aimed to develop a prenatal nursing care catalogue of International Classification for Nursing Practice. As a programme of the International Council of Nurses, International Classification for Nursing Practice aims to support standardized electronic nursing documentation and facilitate collection of comparable nursing data across settings. This initiative enables the study of relationships among nursing diagnoses, nursing interventions and nursing outcomes for best practice, healthcare management decisions, and policy development. The catalogues are usually focused on target populations. Pregnant women are the nursing population addressed in this project. According to the guidelines for catalogue development, three research steps have been adopted: (a) identifying relevant nursing diagnoses, interventions and outcomes; (b) developing a conceptual framework for the catalogue; (c) expert's validation. This project established a prenatal nursing care catalogue with 228 terms in total, including 69 nursing diagnosis, 92 nursing interventions and 67 nursing outcomes, among them, 57 nursing terms were newly developed. All terms in the catalogue were organized by a framework with two main categories, i.e. Expected Changes of Pregnancy and Pregnancy at Risk. Each category had four domains, representing the physical, psychological, behavioral and environmental perspectives of nursing practice. This catalogue can ease the documentation workload among prenatal care nurses, and facilitate storage and retrieval of standardized data for many purposes, such as quality improvement, administration decision-support and researches. The documentations of prenatal care provided data that can be more fluently communicated, compared and evaluated across various healthcare providers and clinic settings. © 2016 International Council of Nurses.
Mackinson, Lynn G; Corey, Juliann; Kelly, Veronica; O'Reilly, Kristin P; Stevens, Jennifer P; Desanto-Madeya, Susan; Williams, Donna; O'Donoghue, Sharon C; Foley, Jane
A nurse project consultant role empowered 3 critical care nurses to expand their scope of practice beyond the bedside and engage within complex health care delivery systems to reduce harms in the intensive care unit. As members of an interdisciplinary team, the nurse project consultants contributed their clinical expertise and systems knowledge to develop innovations that optimize care provided in the intensive care unit. This article discusses the formal development of and institutional support for the nurse project consultant role. The nurse project consultants' responsibilities within a group of quality improvement initiatives are described and their challenges and lessons learned discussed. The nurse project consultant role is a new model of engaging critical care nurses as leaders in health care redesign. ©2018 American Association of Critical-Care Nurses.
Vlasblom, J.P.; Steen, van der J.T.; Knol, D.L.; Jochemsen, H.
Despite the fact that spiritual care is an essential part of nursing care according to many nursing definitions, it appears to be quite different in practice. A spirituality training for nurses may be necessary to give spiritual care the attention it deserves. In a trial a pre-tested “spirituality
Dias, Cristiane Bergues; Aranha e Silva, Ana Luisa
This qualitative study was performed with fourteen nurses of eleven psychosocial care services. The objectives of the study were the following: to characterize the professional profile of the nurses who work in community psychiatric services and to verify those nurses' practice according to the current model of mental health care. there was a prevalence of females; most had over 10 years since their graduation; their entrance in the mental health area is late and is associated with the lack of job opportunities and the fact that the service is close to their home. One part of the nurses found it difficult to define their work at an extra-hospital environment. On the other hand, another group of nurses believes that the nursing work in mental health services is flexible and it is shared with other workers of the multidisciplinary team. Low salaries, poor infrastructure and the lack of team member acknowledgement generate dissatisfaction at work. The Brazilian Psychiatric Reform is associated with dehospitalization.
Jennings, Fiona L; Mitchell, Marion
Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.
Min, So Young
The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.
Denny, Margaret; Higgins, Agnes
Despite the available literature that identifies the value of integrating computer-assisted learning into the curriculum, psychiatric nurse education lags behind in this area of curriculum development. The purpose of this paper is to report on a pilot project involving the use of a computer assisted learning (CAL) interactive multimedia (IMM) package called 'Admissions,' as a self-directed learning tool with two-second year psychiatric nursing students. The students were on a practice placement in an Irish mental health service. The aim of using the multimedia resource was to augment the students' learning during their practice placement and enable them to re-examine the issue of psychosis from a multiplicity of perspectives. This paper provides a brief description of the interactive multimedia package, together with a discussion on the support offered to the students during its use. experiential taxonomy is used as a framework to guide the discussion on the learning and evaluation process used. Feedback from the students suggests that the CAL package is easy to use, informative and promoted independence and self-directed study.
Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H
To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
Thomas, Sandra P
The philosophy of Maurice Merleau-Ponty, a unique blend of existentialism and phenomenology, deserves to be better known in psychiatric-mental health nursing. This philosophy is particularly pertinent to the contemporary recovery movement that seeks to dispel the therapeutic nihilism regarding conditions such as schizophrenia, borderline personality, and substance use disorders. This paper provides an overview of Merleau-Ponty's life and work, with emphasis on selected elements of his philosophy that are inspirational for the clinical practice of psychiatric-mental health nursing. Copyright © 2017 Elsevier Inc. All rights reserved.
Zariquiey-Esteva, G; Galeote-Cózar, D; Santa-Candela, P; Castanera-Duro, A
Botulism is a rare disease in Europe, caused by the bacterium Clostridium botulinum, notifiable, non-transmissible person-to-person and potentially fatal (between 5 and 10%) if not treated quickly. The favourable opinion of the Clinical Research Ethics Committee was obtained. We present the nursing care plan of a 49-year-old man with a diagnosis of bacterial intoxication caused by Clostridium botulinum, secondary to ingestion of beans in poor condition, who was admitted to the ICU for a total of 35 days. Holistic nursing evaluation during the first 24hours, with prioritisation of the systems that were deteriorating fastest: neurological and respiratory. Nine diagnoses were prioritised according to the NANDA taxonomy: Risk for allergy response, Ineffective breathing pattern, impaired oral mucous membrane, Impaired physical mobility, Risk for disuse syndrome, Risk for dysfunctional gastrointestinal motility, Impaired urinary elimination, Risk for acute confusion and Risk for caregiver role strain. The nursing care plan, standardised and organised with the NANDA taxonomy and prioritised with the outcome-present state-test (OPT) model, guaranteed the best care based on evidence, as the NOC scores improvement demonstrated. It was impossible to compare the nursing intervention with other case reports. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.
Scott, P A
Even a brief consideration of the nature of nursing will indicate that an ethical dimension underlies much, if not all, of nursing practice. It is therefore important that students and practitioners are facilitated in developing an ethical awareness and sensitivity from early in their professional development. This paper argues that Aristotelian virtue theory provides a practice-based focus for health care ethics for a number of reasons. Also, because of his emphasis on the character of the moral agent, and on the importance of perception and emotion in moral decision-making, Aristotelian virtue theory provides a useful supplement to the traditional duty-based approaches to health care ethics analysis, which are increasingly being identified in the literature as having limits to their application within the health care context.
Schou, M; Sæther, S G; Borowski, K
BACKGROUND: Autoimmune encephalitis associated with anti-neuronal antibodies may be challenging to distinguish from primary psychiatric disorders. The significance of anti-neuronal antibodies in psychiatric patients without clear evidence of autoimmune encephalitis is unknown. We investigated...... the serum prevalence of six anti-neuronal autoantibodies in a cohort of unselected patients admitted to acute psychiatric care. METHOD: Serum was drawn from 925 patients admitted to acute psychiatric in-patient care. Psychiatric diagnoses were set according to International Classification of Diseases (ICD......)-10 criteria. Antibody analysis was performed with an indirect immunofluorescence test for N-methyl d-aspartate receptor (NMDAR) antibodies and five other anti-neuronal autoantibodies of the immunoglobulin (Ig) classes IgA, IgG and IgM isotype. RESULTS: Anti-neuronal autoantibodies were found in 11...
Liu, Yu-Chieh; Wang, Hui-Yu; Huang, Hui-Ling; Chen, Min-Li
Over half (57.14%) of patients in our ward suffer from abdominal obesity. This rate is on a continuing upward trend. Reasons for such obesity include lack of physical activity classes, inadequate physical activity, high calorie diets and unhealthy eating habits, chronic diseases and drug side effects, poor motivation to reduce weight, and lack of crisis awareness of abdominal obesity. This project was designed to lessen the problem of abdominal obesity among psychiatric day care inpatients. Resolution measures implemented included: (1) arranging aerobic exercise classes; (2) scheduling classes to teach patients healthy diet habits and knowledge regarding diseases and drugs; (3) holding a waistline reduction competition; (4) displaying health education bulletin boards; (5) holding a quiz contest with prizes for correct answers. The eight abdominally obese patients in the ward achieved an average waist circumference reduction of 2.9 cm and the overall abdominal obesity rate in the ward fell to 35.7%. BMI, eating habits, and awareness of weight loss importance and motivation all improved. The outcome achieved targeted project objectives. We recommend the integration of obesity prevention into routine ward activities and quality control indicators. Nurses should provide patients with weight loss concepts, regularly monitor risk factors, and encourage patient family cooperation to maintain medical care quality.
Agyapong, Vincent Israel Opoku
Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.
Levenson, Steven A; Desai, Abhilash K
Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation. The huge negative impact of cognitive biases and rote approaches on related clinical problem solving and decision making and patient outcomes also must be addressed. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Tourangeau, Ann; Patterson, Erin; Rowe, Alissa; Saari, Margaret; Thomson, Heather; MacDonald, Geraldine; Cranley, Lisa; Squires, Mae
To identify factors affecting Canadian home care nurse intention to remain employed (ITR). In developed nations, healthcare continues to shift into community settings. Although considerable research exists on examining nurse ITR in hospitals, similar research related to nurses employed in home care is limited. In the face of a global nursing shortage, it is important to understand the factors influencing nurse ITR across healthcare sectors. A qualitative exploratory descriptive design was used. Focus groups were conducted with home care nurses. Data were analysed using qualitative content analysis. Six categories of influencing factors were identified by home care nurses as affecting ITR: job characteristics; work structures; relationships/communication; work environment; nurse responses to work; and employment conditions. Findings suggest the following factors influence home care nurse ITR: having autonomy; flexible scheduling; reasonable and varied workloads; supportive work relationships; and receiving adequate pay and benefits. Home care nurses did not identify job satisfaction as a single concept influencing ITR. Home care nursing management should support nurse autonomy, allow flexible scheduling, promote reasonable workloads and create opportunities for team building that strengthen supportive relationships among home care nurses and other health team members. © 2013 John Wiley & Sons Ltd.
Winsett, Rebecca P; Rottet, Kendra; Schmitt, Abby; Wathen, Ellen; Wilson, Debra
The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
Liu, Ying; Aungsuroch, Yupin
To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. © 2017 John Wiley & Sons Ltd.
Murphy, Jill; Quillinan, Bernie; Carolan, Mary
Leadership in nursing plays a crucial part in the provision of good patient care. However, the terms 'nursing leadership' and 'nursing management' are often confused. This article discusses the difficulties in defining 'clinical leadership', outlines its development in the Republic of Ireland, and identifies issues that must be addressed if clinical nurse leaders are to be effective.
Walters, Gwendolyn M.
The concept of caring has been integral to the practice of nursing and nursing education since the early teachings of Florence Nightingale. Significant changes in both the practice and the need for educating increasing numbers of advanced-degree nurses have resulted in an increase in online doctoral-level nursing programs. This internet-based…
Naghneh, Mohammad Hossein Khalilzadeh; Tafreshi, Mansoureh Zagheri; Naderi, Manijeh; Shakeri, Nehzat; Bolourchifard, Fariba; Goyaghaj, Naser Sedghi
Nursing care encompasses physical, emotional, mental and social needs, in order to improve a patient's health and wellbeing. Caring is the central core and the essence of nursing. The important issue of care is access to proper care and increasing patients' satisfaction. Job performance of nurses is affected by many factors including organizational commitment. This study aimed to determine the relationship between organizational commitment and nurses caring behavior. In this cross-sectional study, 322 nurses from selected Hospitals of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected and enrolled in the study in 2015. The self-reported data by nurses were collected through demographic characteristics questionnaire, Meyer & Allen organizational commitment model and Caring Behavior Inventory (CBI). Data were analyzed with SPSS statistical software version 20, using t-test and ANOVA. The majority of nurses (63%) were female. The mean score and standard deviation of organizational commitment and caring behavior of nurses were 74.12±9.61 and 203.1±22.46, respectively. The results showed a significantly positive correlation between organizational commitment and caring behavior (p=0.001). In this study the caring behavior of nurses with higher organizational commitment were significantly better than the others. Managers and nurse leaders should pay more attention to improve organizational commitment of nurses, in order to improve nurses' performance.
Jones, Liz; Taylor, Tara; Watson, Bernadette; Fenwick, Jennifer; Dordic, Tatjana
Nursing staff are an important source of support for parents of a hospitalized preterm infant. This study aimed to describe parents' and nurses' perceptions of communicating with each other in the context of the special care nursery. A qualitative descriptive design was employed. Thirty two parents with a newborn admitted to one of two special care nurseries in Queensland, Australia participated, and 12 nurses participated in semi-structured interviews. Thematic analysis was used to analyze the interviews. Nurses and parents focused on similar topics, but their perceptions differed. Provision of information and enabling parenting were central to effective communication, supported by an appropriate interpersonal style by nurses. Parents described difficulties accessing or engaging nurses. Managing enforcement of policies was a specific area of difficulty for both parents and nurses. The findings indicated a tension between providing family-centered care that is individualized and based on family needs and roles, and adhering to systemic nursery policies. Copyright © 2015 Elsevier Inc. All rights reserved.
Kverno, Karan; Kozeniewski, Kate
Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.
Hessels, Amanda J; Flynn, Linda; Cimiotti, Jeannie P; Cadmus, Edna; Gershon, Robyn R M
Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Nurses missed delivering a significant amount of necessary patient care (10-27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.
This survey describes caring in the workplace in selected health services and is part of a greater study conducted in KwaZulu-Natal, South Africa. This study describes the views of nurse managers and nurses regarding caring in the workplace. Human competence, recovery and healing are central to caring. To ensure caring and healing of patients in health services it is of the utmost importance for nurse managers to ensure a healthy and caring environment in the management of nurses. When caring is present in the workplace, nurses are more able to render caring nursing practices in the patient care environment. It is clear that to become a caring person, one must be treated in a caring way and that caring may be impaired or reinforced by the environment. The environment of interest to this study was the environment in which nurses practise. A descriptive survey with a convenience sampling explored caring in the workplace of nurses. The questionnaire was divided into two sections. Section A comprised demographic information and in section B the questionnaire consisted of Likert type questions, open-ended questions and yes/no questions. Analysis included descriptive statistics. It was found that caring was not experienced in the hospitals by nurses in the major management tasks such as respect for human dignity, two-way communication, trust between nurses and nurse managers, wellness, cultural sensitivity, support and the recognition and handling of the concerns of nurses. It was clear that although nurse managers and nurses have the knowledge and structures for the implementation of caring in the hospitals, the everyday practical application of caring needs attention. Nurse managers were aware of caring practices but nurses did not always experience caring in their places of work in the hospitals. Nurse managers and nurses should all accept responsibility for finding means to improve communication and, in particular, participative leadership strategies in the hospitals
The closure of forensic hospitals and the implications for nursing care. The closure of forensic hospitals led to the opening of new wards to admit psychiatric patients who committed a crime and by Italian law, cannot be imprisoned. Over 826 residents of forensic hospitals, around 350 cannot be discharged because considered dangerous for the society. The new wards where these patients will be admitted raise some legal and ethical problems as health professionals (doctors and nurses) will be responsible not only of the patients health but also of their legal custody. The professional and ethical implications need a debate among professionals.
Tan, Yung-Ming; Hii, Joshua; Chan, Katherine; Sardual, Robert; Mah, Benjamin
With the introduction of CPOE systems, nurses in a Singapore hospital were facing difficulties monitoring key patient information such as critical tasks and alerts. Issues include unfriendly user interfaces of clinical systems, information overload, and the loss of visual cues for action due to paperless workflows. The hospital decided to implement an interactive electronic dashboard on top of their CPOE system to improve visibility of vital patient data. A post-implementation survey was performed to gather end-user feedback and evaluate factors that influence user satisfaction of the dashboard. Questionnaires were sent to all nurses of five pilot wards. 106 valid responses were received. User adoption was good with 86% of nurses using the dashboard every shift. Mean satisfaction score was 3.6 out of 5. User satisfaction was strongly and positively correlated to the system's perceived impact on work efficiency and care quality. From qualitative feedback, nurses generally agreed that the dashboard had improved their awareness of critical patient issues without the hassle of navigating a CPOE system. This study shows that an interactive clinical dashboard when properly integrated with a CPOE system could be a useful tool to improve daily patient care.
Voldbjerg, Siri; Laugesen, Britt; Bahnsen, Iben Bøgh
AIM AND OBJECTIVES: To describe and discuss the process of integrating the Fundamentals of Care framework in a baccalaureate nursing education at a School of Nursing in Denmark. BACKGROUND: Nursing education plays an essential role in educating nurses to work within health care systems in which...... Fundamentals of Care framework has been integrated in nursing education at a School of Nursing in Denmark. DESIGN AND METHODS: Discursive paper using an adjusted descriptive case study design for describing and discussing the process of integrating the conceptual Fundamentals of Care Framework in nursing...... education. RESULTS: The process of integrating the Fundamentals of Care framework is illuminated through a description of the context, in which the process occurs including the faculty members, lectures, case-based work and simulation lab in nursing education. Based on this description, opportunities...
Iancu, S.C.; Zweekhorst, M.B.M.; Veltman, D.J.; van Balkom, A.J.L.M.; Bunders-Aelen, J.G.F.
Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were
Nursing has always regarded caring as its core business. The historical record about caring in nursing is non-specific, and little direct evidence exists about caring as part of nursing. Caring is not restricted to nursing, is possibly influenced by public perceptions of nursing, and can be subverted for maleficent ends. This paper discusses these points, and then moves to explain how caring fares in the Australian health care system. Australia has been blighted by a "cultural cringe" which sees anything from overseas as more valuable than anything Australian. This is as true for nursing, and caring within that, as for any other aspect of Australian life. However, Australia has one of the best health care systems in the world, and nursing as a profession is a world leader. The argument of this paper is that the core business of caring could be under threat in Australia unless nurses recognize their particularly good contribution to the profession and subsequent patient/client care, and celebrate that. Examples are taken from the United Kingdom where there is a crisis of caring within nursing and health. These are used to explain how Australian nursing can avoid the pitfalls and retain caring as its core business.
Background. A global shortage of registered nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical care nurses (CCNs) especially are in great demand and short supply. Purpose. The purpose of this study was to quantify the nursing workforce ...
The Affordable Care Act gives America's largest group of health care providers--nurses--a unique chance to lead in improving outcomes, increasing patient satisfaction, and lowering costs. Nurses' roles continue to grow in settings from hospitals and long-term care facilities to home health and hospice agencies. Nurses are also key players in private duty home care, where they serve as care coordinators for clients. Working directly with doctors, therapists, in-home caregivers, and families, nurses are critical in delivering quality, seamless in-home care.
The thesis deals with the nursing care of newborns with hyperbilirubinemia. It is processed in the form of case study. It consists of a theoretical and a practical part. There are described hyperbilirubinemia, its occurrence, incidence, symptoms and causes in theoretical part. Furthermore the work describes the pathophysiology of hyperbilirubinemia, where is mentioned the metabolism of bilirubin and its toxicity. The thesis continues by hyperbilirubinemia splitting, describes the most common ...
Internal radiation therapy has been used in treating gynecological cancers for over 100 years. A variety of radioactive sources are currently used alone and in combination with other cancer treatments. Nurses need to be able to provide safe, comprehensive care to patients receiving internal radiation therapy while using precautions to keep the risks of exposure to a minimum. This article discusses current trends and issues related to such treatment for gynecological cancers.20 references
Sun, Bin; Fan, Ni; Nie, Sha; Zhang, Minglin; Huang, Xini; He, Hongbo; Rosenheck, Robert A
Stigma towards people with mental illness is believed to be widespread in low and middle income countries. This study assessed the attitudes towards people with mental illness among psychiatrists, psychiatric nurses, involved family members of patients in a psychiatric facility and the general public using a standard 43-item survey (N = 535). Exploratory factor analysis identified four distinctive attitudes which were then compared using Analysis of Covariance (ANCOVA) among the four groups, all with ties to the largest psychiatric facility in Guangzhou, China, adjusting for sociodemographic differences. Four uncorrelated factors expressed preferences for 1) community-based treatment, social integration and a biopsychosocial model of causation, 2) direct personal relationships with people with mental illness, 3) a lack of fear and positive views of personal interactions with people with mental illness, 4) disbelief in superstitious explanations of mental illness. Statistically significant differences favored community-based treatment and biopsychosocial causation (factor 1) among professional groups (psychiatrists and nurses) as compared with family members and the general public (p problems of their relatives and support in their care.
Taylor, Elizabeth Johnston; Gober-Park, Carla; Schoonover-Shoffner, Kathy; Mamier, Iris; Somaiya, Chintan K; Bahjri, Khaled
This study measured the frequency of nurse-provided spiritual care and how it is associated with various facets of nurse religiosity. Data were collected using an online survey accessed from the home page of the Journal of Christian Nursing. The survey included the Nurse Spiritual Care Therapeutics Scale, six scales quantifying facets of religiosity, and demographic and work-related items. Respondents ( N = 358) indicated high religiosity yet reported neutral responses to items about sharing personal beliefs and tentativeness of belief. Findings suggested spiritual care was infrequent. Multivariate analysis showed prayer frequency, employer support of spiritual care, and non-White ethnicity were significantly associated with spiritual care frequency (adjusted R 2 = .10). Results not only provide an indication of spiritual care frequency but empirical encouragement for nurse managers to provide a supportive environment for spiritual care. Findings expose the reality that nurse religiosity is directly related, albeit weakly, to spiritual care frequency.
Anna Maria Kostka
Full Text Available Everyone has the right to equal treatment irrespective of color, culture, origin or religion. Jewish patients obey many rules. The use of proper diet, adherence to the principles of purity, prayer, performing rituals is very important for them. Medical staff is committed to providing patients with safety, regardless of the differences. Understanding the most important values, ethics and practices of Judaism will help to provide professional care for the patient of Jewish faith. Appropriate communication, understanding and tolerance are essential for creating a relationship with the patient, through which it will be possible to achieve the desired therapeutic effect and improve the quality of life of patients.
Kiljunen, Outi; Välimäki, Tarja; Kankkunen, Päivi; Partanen, Pirjo
People living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well-being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing. The aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes. Integrative literature review. We performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis. Ten articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence-based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce. The competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context. Well-educated nursing staff are needed in care and nursing homes to provide high-quality care because comprehensive and advanced nurse competence is required to meet the needs of older people. © 2016 John Wiley & Sons Ltd.
Vincze, Mattias; Fredriksson, Lennart; Wiklund Gustin, Lena
Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients. © 2015 Australian College of Mental Health Nurses Inc.
Jung, Dukyoo; Kim, Jung-Hee
A nursing record focused on sexual health care for patients with cancer could encourage oncology nurses to provide sexual health care for oncology patients in a simple and effective manner. However, existing electronic information systems focus on professional use and not sexual health care, which could lead to inefficiencies in clinical practice. To examine the effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Twenty-four full-time registered nurses caring for oncology patients were randomly assigned to the intervention and control groups in Korea. The researchers developed a sexual health care record and applied it to the intervention group for one month. Data were analyzed by Mann-Whitney U test and chi-square test. Content analysis was used to analyze interviews. Oncology nurses using the sexual health care record had significantly higher levels of sexual health care practice at 4 weeks post-intervention as compared to those who provided usual care to patients with cancer. A sexual health care record may have the potential to facilitate oncology nurses' practice of sexual health care. This study highlighted the importance of using SHC records with oncology patients to improve nursing practice related to sexuality issues. A nursing record focused on SHC for patients with cancer could make it easier and more effective for oncology nurses to provide such care to their patients. Copyright © 2016 Elsevier B.V. All rights reserved.
Full Text Available Jehovah's Witnesses is a religious association, who refuses blood transfusions even in life-threatening conditions. There are several alternative methods, implemented for use with patients that religion, whose task is to reduce the risk of bleeding and hemorrhage in the perioperative period. Good cooperation of the therapeutic team, the selection of appropriate treatment, the use of recommended methods of anesthesia, surgical techniques and proper nursing care with careful monitoring of post-operative complications and quick response if they leave, they contribute to the improvement of health.
Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; givari, Azam; Haghani, Hamid
Background: Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-be...
conditions, their methods of work, selection and ... nursing; low pay for hard work; poor, often unsafe .... 115. Table 1. Perceived Image of Nursing as a Field for Women and Men, Jimma, June- .... stereotyping, nursing is the most severely.
Duke, Jan; Connor, Margaret
Like the general population, nurses become patients within the health care services available to them. They write anecdotal accounts of their experience and research the experience of their colleagues. This paper reports a small descriptive study of how the positions of senior nurses who experienced a life threatening condition influenced their illness trajectories. Eleven nurses in both New Zealand and Australia told stories of their experiences which focussed on intercessions/intervention by themselves, their family and the health care team. Themes identified were: looking after our own, the gaze of family and friends in advocacy and intercession, stereotypes of nurses as patients, senior nurses as vulnerable patients - existential healing through the small things, and senior nurses as knowledgeable people. Within these themes were narratives of special and meagre care. The authors conclude that all senior nurses should receive care that is regardful of who they are as senior nurses and vulnerable patients.
Dubois, Carl-Ardy; D'Amour, Danielle; Tchouaket, Eric; Rivard, Michèle; Clarke, Sean; Blais, Régis
Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units' profile data. The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses' professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses' perceptions that the practice environment is less supportive of their professional work. This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an "ideal" nursing professional practice model described by some leaders in the
Galbany-Estragués, Paola; Comas-d'Argemir, Dolors
Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.
D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )
textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between
Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani
to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.
Gonge, Henrik; Buus, Niels
This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and...... in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision......., and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff......'s existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were...
Williams, Susan G; Godfrey, Alice J
Cyberbullying is an emerging issue within our society, particularly among adolescents. The phenomenon is similar to traditional bullying in that it is hurtful, repetitive behavior involving a power imbalance, often causing psychosocial issues. With the availability of cell phones, Internet, and video gaming systems, adolescents are constantly plugged into technology and therefore at risk of being a victim or a perpetrator of cyberbullying. Both physical and mental health problems can result from cyberbullying, which, in turn, can affect an adolescent's performance in school and other crucial areas of life. Legal action is an option, but many times the law is not clear. Psychiatric-mental health nurses are in a position to help educate children about resources to prevent or cope with cyberbullying in a way that will help not only the patients themselves but also parents, teachers, school administrators, and the community. Copyright 2011, SLACK Incorporated.
A.M. de Kleijn
Full Text Available Recently we have been made aware by our nursing leaders that the nurse must extend her role. Professor Eleanor Lambertson, Dean of the School of Nursing. Cornell University, New York, has said and I quote: “It is my premise that until and unless nurses willingly face the issues associated with the extension of their scope of practice, nurses will become obsolete in terms of today’s and tomorrow’s need for health care services.”
This qualitative study explores how Catholicism influenced nursing in Catholic hospitals and how nurses met the religious needs of Catholic patients in the 1950s and early 1960s. Six nurses were interviewed who graduated from Catholic schools of nursing between 1952 and 1965 and worked in Catholic hospitals. Results indicate that nursing care was inexorably entwined with meeting the religious needs of Catholic patients. Religious practices were predictable and largely linked to the Holy Sacraments.
Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system ...
Rush, Kathy L; Hickey, Stormee; Epp, Sheila; Janke, Robert
To examine hospital nurses' attitudes towards caring for older adults and delineate associated factors contributing to their attitudes. Population ageing is of international significance. A nursing workforce able to care for the ageing population is critical for ensuring quality older adult care. A synthesis of research related to nurses' attitudes towards older adult care is important for informing care quality and the nursing workforce issues. A systematic integrative review process guided the review. Cumulative Index of Nursing and Allied Health Literature and Medline databases were searched for primary research published between 2005-2017. A total of 1,690 papers were screened with 67 papers read in-depth and eight selected for this review that met the inclusion/exclusion criteria. Nurses' held coexisting positive and negative attitudes towards generic and specific aspects of older adult care. Negative attitudes, in particular, were directed at the characteristics of older adults, their care demands or reflected in nurses' approaches to care. Across jurisdictions, work environment, education, experience and demographics emerged as influences on nurses' attitudes. There is a paucity of research examining nurses' attitudes towards older adult care. The limited evidence indicates that attitudes towards older people care are complex and contradictory. Influences on nurses' attitudes need further study individually and collectively to build a strong evidence base. Interventional studies are needed as are the development of valid and reliable instruments for measuring nurses' attitudes towards older adult care. Bolstering postgraduate gerontological preparation is critical for promoting nurses' attitudes towards older adult care. Creating age-friendly work environments, including appropriate resource allocation, is important to support older people care and facilitate positive nursing attitudes. © 2017 John Wiley & Sons Ltd.
Zengin, A Z; Yanik, K; Celenk, P; Unal-Erzurumlu, Z; Yilmaz, H; Bulut, N
The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. Chi-square test and z-test were used. All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus0 (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.
Vardell, Emily; Paulaitis, Gediminas Geddy
Nursing Reference Center is a point-of-care resource designed for the practicing nurse, as well as nursing administrators, nursing faculty, and librarians. Users can search across multiple resources, including topical Quick Lessons, evidence-based care sheets, patient education materials, practice guidelines, and more. Additional features include continuing education modules, e-books, and a new iPhone application. A sample search and comparison with similar databases were conducted.
Rosa del Socorro Morales-Aguilar; Gloria Elena Lastre-Amell; Alba Cecilia Pardo-Vásquez
Introduction: the theoretical and methodological components are the proper expertise in nursing, and it refers to models, theories, care process, taxonomy of nursing diagnoses, system of nursing intervention classification, and system of outcomes classification, which base nursing care into professional practice. Methodology: research was performed on Google Scholar, reviewing the databases of Scielo, Ciberindex, Index Enfermería, Dialnet, Redalyc, Medline, identifying 70 published articles b...
Wagner, Debra; Bear, Mary
This paper is a report of a concept analysis of patient satisfaction with nursing care. Patient satisfaction is an important indicator of quality of care, and healthcare facilities are interested in maintaining high levels of satisfaction in order to stay competitive in the healthcare market. Nursing care has a prominent role in patient satisfaction. Using a nursing model to measure patient satisfaction with nursing care helps define and clarify this concept. Rodgers' evolutionary method of concept analysis provided the framework for this analysis. Data were retrieved from the Cumulative Index of Nursing and Allied Health Literature and MEDLINE databases and the ABI/INFORM global business database. The literature search used the keywords patient satisfaction, nursing care and hospital. The sample included 44 papers published in English, between 1998 and 2007. Cox's Interaction Model of Client Health Behavior was used to analyse the concept of patient satisfaction with nursing care. The attributes leading to the health outcome of patient satisfaction with nursing care were categorized as affective support, health information, decisional control and professional/technical competencies. Antecedents embodied the uniqueness of the patient in terms of demographic data, social influence, previous healthcare experiences, environmental resources, intrinsic motivation, cognitive appraisal and affective response. Consequences of achieving patient satisfaction with nursing care included greater market share of healthcare finances, compliance with healthcare regimens and better health outcomes. The meaning of patient satisfaction continues to evolve. Using a nursing model to measure patient satisfaction with nursing care delineates the concept from other measures of patient satisfaction.
Full Text Available Mental health problems among adolescents have become a major public health issue, and it is therefore important to increase knowledge on the contextual determinants of adolescent mental health. One such determinant is the socioeconomic structure of the neighbourhood. The present study has two central objectives, (i to examine if neighbourhood socioeconomic deprivation is associated to individual variations in utilisation of psychiatric care in a Swedish context, and (ii to investigate if neighbourhood boundaries are a valid construct for identifying contexts that influence individual variations in psychiatric care utilization. Data were obtained from the Longitudinal Multilevel Analysis in Scania (LOMAS database. The study population consists of all boys and girls aged 13-18 years (N=18,417, who were living in the city of Malmö, Sweden, in 2005. Multilevel logistic regression analysis was applied to estimate the probability of psychiatric care utilisation. The results from the study indicate that the neighbourhood of residence had little influence on psychiatric care utilisation. Although we initially found a variation between neighbourhoods, this general contextual effect was very small (i.e. 1.6%. The initial conclusive association between the neighbourhood level of disadvantage and psychiatric care utilisation (specific contextual effect disappeared following adjustment for individual and family level variables. Our results suggest the neighbourhoods in Malmö (at least measured in terms of SAMS-areas, do not provide accurate information for discriminating adolescents utilisation of psychiatric care. The SAMS-areas appears to be an inappropriate construct of the social environment that influences adolescent utilisation of psychiatric care. Therefore, public health interventions should be directed to the whole city rather than to specific neighbourhoods. However, since geographical, social or cultural contexts may be important for our
Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke
The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.
Ewertzon, Mats; Alvariza, Anette; Winnberg, Elisabeth; Leksell, Janeth; Andershed, Birgitta; Goliath, Ida; Momeni, Pardis; Kneck, Åsa; Skott, Maria; Årestedt, Kristofer
To adapt the Family Involvement and Alienation Questionnaire (FIAQ) for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability. Involvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed. A psychometric evaluation study, with a cross-sectional design. The content validity of the FIAQ was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used. The content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the FIAQ (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability. The study provides evidence that the FIAQ (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. © 2018 John Wiley & Sons Ltd.
Tume, Lyvonne N; Coetzee, Minette; Dryden-Palmer, Karen; Hickey, Patricia A; Kinney, Sharon; Latour, Jos M; Pedreira, Mavilde L G; Sefton, Gerri R; Sorce, Lauren; Curley, Martha A Q
To identify and prioritize research questions of concern to the practice of pediatric critical care nursing practice. One-day consensus conference. By using a conceptual framework by Benner et al describing domains of practice in critical care nursing, nine international nurse researchers presented state-of-the-art lectures. Each identified knowledge gaps in their assigned practice domain and then poised three research questions to fill that gap. Then, meeting participants prioritized the proposed research questions using an interactive multivoting process. Seventh World Congress on Pediatric Intensive and Critical Care in Istanbul, Turkey. Pediatric critical care nurses and nurse scientists attending the open consensus meeting. Systematic review, gap analysis, and interactive multivoting. The participants prioritized 27 nursing research questions in nine content domains. The top four research questions were 1) identifying nursing interventions that directly impact the child and family's experience during the withdrawal of life support, 2) evaluating the long-term psychosocial impact of a child's critical illness on family outcomes, 3) articulating core nursing competencies that prevent unstable situations from deteriorating into crises, and 4) describing the level of nursing education and experience in pediatric critical care that has a protective effect on the mortality and morbidity of critically ill children. The consensus meeting was effective in organizing pediatric critical care nursing knowledge, identifying knowledge gaps and in prioritizing nursing research initiatives that could be used to advance nursing science across world regions.
Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah
Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.
Griffiths, P; Goryakin, Y.; Maben, J.
OBJECTIVE: Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provide...
Lydia V. Monareng
Full Text Available Spiritual nursing care is a significant concept for nurses as they are expected to provide holistic care to patients. Many nurses have difficulty to understand and integrate it into practice and consequently neglect this aspect of care. The study was conducted to explore and describe how professional nurses provide spiritual care to patients. A generic qualitative, explorative and descriptive study was conducted based on Symbolic Interactionism as the philosophical base. The population comprised professional nurses from a public hospital. Participants were recruited through purposive and snowball sampling methods. Data were collected through the use of individual, focus group interviews and observation. Data analysis methods utilised included the NUD*ISTcomputer program, coding, constant comparison method and Tesch’s guidelines on data analysis. Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer with or for patients and singing spiritual songs had the highest count of interventions perceived to be effective. Recommendations suggest that the scope of practice and curriculum of training of nurses be reviewed to consider how spiritual nursing care can be evidenced and realised both in the classroom and in the clinical setting. Spiritual nursing care is still a neglected and seemingly complex component of patient care. However, the scientific worldview practices, beliefs and insufficient statutory endorsement of such care hamper its realisation in practice.
Taylor, Elizabeth Johnston; Mamier, Iris; Ricci-Allegra, Patricia; Foith, Joanne
To describe how frequently RNs provide 17 spiritual care therapeutics (or interventions) during a 72-80h timeframe. Plagued by conceptual muddiness as well as weak methods, research quantifying the frequency of spiritual care is not only methodologically limited, but also sparse. Secondary analysis of data from four studies that used the Nurse Spiritual Care Therapeutics Scale (NSCTS). Data from US American RNs who responded to online surveys about spiritual care were analyzed. The four studies included intensive care unit nurses in Ohio (n=93), hospice and palliative care nurses across the US (n=104), nurses employed in a Christian health care system (n=554), and nurses responding to an invitation to participate found on a journal website (n=279). The NSCTS mean of 38 (with a range from 17 to 79 [of 85 possible]) suggested respondents include spiritual care therapeutics infrequently in their nursing care. Particularly concerning is the finding that 17-33% (depending on NSCTS item) never completed a spiritual screening during the timeframe. "Remaining present just to show caring" was the most frequent therapeutic (3.4 on a 5-point scale); those who practiced presence at least 12 times during the timeframe provided other spiritual care therapeutics more frequently than those who offered presence less frequently. Findings affirm previous research that suggests nurses provide spiritual care infrequently. These findings likely provide the strongest evidence yet for the need to improve spiritual care education and support for nurses. Copyright © 2017 Elsevier Inc. All rights reserved.
Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition. © The Author(s) 2014.
Passarella, P M; Lewis, N
The nursing approach in the care of stroke patients has a direct impact on functional outcome. Nursing application of Bobath principles in stroke care offers a nursing focus on involvement of the affected side; facilitation of normal tone, posture, and movement; and development of more normal function. A research study evaluating the functional gains of stroke patients demonstrated a significant level of functional improvement in those treated with Bobath principles over stroke patients treated with the traditional nursing approach. Practical methods for applying Bobath principles in patient care activities are described. These therapeutic methods provide nurses with the means to maximize stroke patients' potential and further influence their functional recovery.
Sawatzky, Jo-Ann V; Enns, Carol L; Ashcroft, Terri J; Davis, Penny L; Harder, B Nicole
Nursing education plays a central role in the ability to practice effectively. It follows that an optimally educated nursing workforce begets optimal patient care. A framework for excellence in nursing education could guide the development of novice educators, establish the basis for evaluating teaching excellence, and provide the impetus for research in this area. However, a review of the social sciences and nursing literature as well as a search for existing models for teaching excellence revealed an apparent dearth of evidence specific to excellence in nursing education. Therefore, we developed the Caring Framework for Excellence in Nursing Education. This framework evolved from a review of the generic constructs that exemplify teaching excellence: excellence in teaching practice, teaching scholarship, and teaching leadership. Nursing is grounded in the ethic of caring. Hence, caring establishes the foundation for this uniquely nursing framework. Because a teaching philosophy is intimately intertwined with one's nursing philosophy and the ethic of caring, it is also fundamental to the caring framework. Ideally, this framework will contribute to excellence in nursing education and as a consequence excellence in nursing practice and optimal patient care.
Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of
unable to recognize what needs to be done, or lacking motivation . Likewise, head nurses may spend too much time giving Cdirect care (14.5%). Perhaps more...of the head nurse time might be redirected to teaching, supervising, and motivating other staff members. Although the objective data are reliable, the...S7 9 1 a NO .06 P4 Z& V- N. 4 1 oe a ~~3 00 0I xI %A II I-~~~- Lai - E, zCk u atII C.p UA a 5 P44 d4. Ps4 .- U)2 co Ili L I ao r40 ey . 1a ,o 01 K
Negarandeh, Reza; Hooshmand Bahabadi, Abbas; Aliheydari Mamaghani, Jafar
The purpose of the study was to determine the impact of regular nursing rounds on patient satisfaction with nursing care. This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward were allocated to control and experimental groups through convenience sampling. The experimental group received regular nursing rounds every 1-2 hours. Routine care was performed for the control group. Patient satisfaction with the quality of nursing care was assessed on the second and fifth days of hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire. On the second day, patient satisfaction scores of the two groups had no significant difference (p = .499). However, the intervention was associated with statistically significant increased patient satisfaction in the experimental group compared to the control group (p patient satisfaction. This method may hence improve patient-nurse interactions and promote the quality of nursing care and patient satisfaction. Copyright © 2014. Published by Elsevier B.V.
Savaşan, Ayşegül; Çam, Olcay
People with alcohol dependency have lower self-esteem than controls and when their alcohol use increases, their self-esteem decreases. Coping skills in alcohol related issues are predicted to reduce vulnerability to relapse. It is important to adapt care to individual needs so as to prevent a return to the cycle of alcohol use. The Tidal Model focuses on providing support and services to people who need to live a constructive life. The aim of the randomized study was to determine the effect of the psychiatric nursing approach based on the Tidal Model on coping and self-esteem in people with alcohol dependency. The study was semi-experimental in design with a control group, and was conducted on 36 individuals (18 experimental, 18 control). An experimental and a control group were formed by assigning persons to each group using the stratified randomization technique in the order in which they were admitted to hospital. The Coping Inventory (COPE) and the Coopersmith Self-Esteem Inventory (CSEI) were used as measurement instruments. The measurement instruments were applied before the application and three months after the application. In addition to routine treatment and follow-up, the psychiatric nursing approach based on the Tidal Model was applied to the experimental group in the One-to-One Sessions. The psychiatric nursing approach based on the Tidal Model is an approach which is effective in increasing the scores of people with alcohol dependency in positive reinterpretation and growth, active coping, restraint, emotional social support and planning and reducing their scores in behavioral disengagement. It was seen that self-esteem rose, but the difference from the control group did not reach significance. The psychiatric nursing approach based on the Tidal Model has an effect on people with alcohol dependency in maintaining their abstinence. The results of the study may provide practices on a theoretical basis for improving coping behaviors and self-esteem and
Beatriz Francisco Farah
Full Text Available Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods: this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results: two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.
de Rezende, Rachel de Carvalho; de Oliveira, Rosane Mara Pontes; de Araújo, Sílvia Teresa Carvalho; Guimarães, Tereza Cristina Felippe; do Espírito Santo, Fátima Helena; Porto, Isaura Setenta
to classify body language used in nursing care, and propose "Body language in nursing care" as an analytical category for nursing communication. quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions. sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches. nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classified body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
de Pires, Denise Elvira Pires
The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care.
Vázquez-Calatayud, Mónica; Oroviogoicoechea, Cristina; Saracibar, Maribel; Pumar-Méndez, María J
Although the concept of 'Transforming care' is promising for improving health care, there is no consensus in the field as to its definition. The aim of this concept analysis is to develop a deeper understanding of the term 'Transforming care' within the nursing discipline, in order to facilitate its comprehension, implementation, and evaluation. We performed a comprehensive literature review on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Web of Science, Wiley-Blackwell, ScienceDirect, and SpringerLink and used Walker and Avant's approach to analyse the concept. From the 20 studies selected for this analysis, 3 main attributes of 'Transforming care' were identified: patient-centredness, evidence-based change, and transformational leadership driven. We suggest an operational definition to facilitate the implementation of the concept in practice. Furthermore, we propose that implementation is guided by the following key ideas: (1) fostering a culture of continuous improvement; (2) encouraging bottom-up initiatives; (3) promoting patient-centred care; and (4) using transformational leadership. Lastly, the evaluation of 'Transforming care' initiatives should assess care processes and professionals' and patients' outcomes.
Robin L. Gabriels
Full Text Available Pediatric patients with autism spectrum disorders (ASD and/or intellectual disabilities (ID are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children’s hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33% and decreased average lengths of inpatient stay (as short as 26 days versus 45 days. Available data from a subset of patients (=43 in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes.
Koekkoek, Bauke; van Meijel, Berno; Schene, Aart; Hutschemaekers, Giel
'difficult patients' may evoke strong feelings in health professionals. The ambivalent attitude of, especially, non-psychotic chronic patients towards psychiatric care may be frustrating and burdensome to professionals. Many of these patients are cared for in non-specialized services, where
Koekkoek, B.W.; Meijel, B.K.G. van; Schene, A.H.; Hutschemaekers, G.J.M.
Aims - 'difficult patients' may evoke strong feelings in health professionals. The ambivalent attitude of, especially, non-psychotic chronic patients towards psychiatric care may be frustrating and burdensome to professionals. Many of these patients are cared for in non-specialized services, where
Bowers, L.; Simpson, A.; Nijman, H.L.I.; Hall, C.
Psychiatric care units provide care to disturbed patients in a context of higher security and staffing levels. Although such units are numerous, few systematic comparisons have been made, and there are indications that ethnic minority groups may be over-represented. The aim of this study was to
Full Text Available This survey describes caring in the workplace in selected health services and is part of a greater study conducted in KwaZulu-Natal, South Africa. This study describes the views of nurse managers and nurses regarding caring in the workplace. Human competence, recovery and healing are central to caring. To ensure caring and healing of patients in health services it is of the utmost importance for nurse managers to ensure a healthy and caring environment in the management of nurses. When caring is present in the workplace, nurses are more able to render caring nursing practices in the patient care environment. It is clear that to become a caring person, one must be treated in a caring way and that caring may be impaired or reinforced by the environment. The environment of interest to this study was the environment in which nurses practise. A descriptive survey with a convenience sampling explored caring in the workplace of nurses. The questionnaire was divided into two sections. Section A comprised demographic information and in section B the questionnaire consisted of Likert type questions, open-ended questions and yes/no questions. Analysis included descriptive statistics.
Although the nursing profession has traditionally been associated with compassionate, patient, and caring behaviors, living in this advanced technological environment where patient related skills and tasks are often rushed caring behaviors are sometimes not seen. In order to improve high school nursing assistant student caring behaviors as well…
Gusdal, Annelie K; Josefsson, Karin; Thors Adolfsson, Eva; Martin, Lene
Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure. To involve family members in heart failure care is thus valuable for the patients. Registered nurses frequently meet family members of patients with heart failure and the quality of these encounters is likely to be influenced by the attitudes registered nurses hold toward families. To explore registered nurses' attitudes toward the importance of families' involvement in heart failure nursing care and to identify factors that predict the most supportive attitudes. Cross-sectional, multicentre web-survey study. A sample of 303 registered nurses from 47 hospitals and 30 primary health care centres completed the instrument Families' Importance in Nursing Care - Nurses' Attitudes. Overall, registered nurses were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in heart failure nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a primary health care centre, a heart failure clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and/or heart failure nursing care, and a competence to work with families. Experienced registered nurses in heart failure nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. Registered nurses who have designated consultation time with patients and families, as in a nurse-led heart failure clinic, may have the most favourable condition for implementing a more supportive approach to families.
Taylor, Elizabeth Johnston; Testerman, Nancy; Hart, Dynnette
Graduating nurses are required to know how to support patient spiritual well-being, yet there is scant literature about how spiritual care is taught in undergraduate programs. Typically spiritual content only is sporadically included; the authors recommend intergrating spiritual can thoughout the nursing curriculum. This article describes how one Christian nursing school integrates spiritual care content, supports student spiritual well-being throughout the program, and evaluates spiritual care instruction at graduation.
Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro
The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.
Smith, Kylie M; Crookes, Patrick A
To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research. It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required. In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants. The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing. The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a national scheme. The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century. © 2012 Blackwell Publishing Ltd.
G. R. Gardanova
Full Text Available The article considers actual issues of psychosocial rehabilitation at the present stage of psychiatric care to the population of the Oryol region.The purpose. Study and generalize the experience of the use of methods of psychosocial rehabilitation in several psychiatric institutions of the Oryol region.Materials and methods. 1. The analysis of activity of out-patient departments, where we developed a new "development Program of sociorehabilitation service in regional psychoneurologic dispensary". 2. Analysis of the activity of hospital services, where the main role is played by psycho-social rehabilitation. 3. The analysis of new forms of psychosocial rehabilitation: in terms of the specifics of Oryol oblast psychiatric hospital of specialized type with intensive supervision (OPHSTIO.Results. As a result of the analysis we identified the most effective methods of sociorehabilitation: outpatient: "Social card of the outpatient" is intended for persons in need of social, psychological, legal and other professional assistance, that allows to plan and control the types of assistance provided. The organization of a hostel for patients at the outpatient stage, which allowed to introduce a "full" recovery cycle. In OPHSTIO — implementation of multiprofessional teams and "sick tips" and the opening of an Orthodox chapel of the Mother of God icon "All grieving pleasures".Conclusions. Methods of psychosocial rehabilitation allowed to optimize the work of the main stages of treatment and rehabilitation processes, to provide in a timely manner the necessary comprehensive care to patients based on individual needs of the mentally ill in the outpatient and inpatient therapy in the Oryol region.
Background Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features. Methods This study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data. Results The study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work. Conclusions This study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice
Sagherian, Knar; Clinton, Michael E; Abu-Saad Huijer, Huda; Geiger-Brown, Jeanne
Hospital nurses are expected to maintain optimal work performance; yet, fatigue can threaten safe practice and result in unfavorable patient outcomes. This descriptive cross-sectional study explored the association between fatigue, work schedules, and perceived work performance among nurses. The study sample included 77 bedside nurses who were mostly female, single, and between 20 and 29 years of age. The majority worked 8-hour shifts and overtime. Nurses who worked during off days reported significantly higher chronic fatigue compared with those nurses who took time off. Nurses who reported feeling refreshed after sleep had significantly less chronic and acute fatigue and more intershift recovery. Nurses with acute and chronic fatigue perceived poorer physical performance. Also, nurses who reported chronic fatigue perceived they were less alert and less able to concentrate when providing patient care. Less effective communication was also associated with acute and chronic fatigue. In conclusion, fatigue has safety implications for nurses' practice that should be monitored by nursing management.
Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane
To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. Seventy-five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.
Kuo, Chien-Lin; Lee-Hsieh, Jane; Wang, Pi-Ling
Caring is the essence of nursing and the core of nursing education. This paper describes the experience of developing a caring curriculum in a five-year junior college nursing program which included three core courses in caring, in the hope of stimulating further dialogue with fellow educators and cultivating students' caring competencies. The first course was Introduction to Caring, which gave students an understanding of basic concepts of caring, along with the opportunity to practice and experience caring by caring for oneself, one's family and one's peers. The second course was Application of Caring Concepts, which enabled students to learn about caring models, especially the dynamic caring model, and expanded their knowledge of caring behaviors from interpersonal caring to caring for society. The third course was Professional Caring, which explained professional caring and related caring theories, and introduced the caring model used in nursing in Taiwan, showing students how to practice caring in clinical situations. The participating teachers used the action research method to plan, design, implement, and evaluate the caring curriculum. These teachers set the teaching objectives and developed course materials by working together in workshops and participating in teachers' caring groups. They adopted various teaching strategies, such as role modeling, dialogue, caring groups, confirmation, literature, film, caring action projects, reflection, and journaling, which have been proven to be effective at raising students' learning motivation and caring performance.
Garwick, Ann W; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M; Looman, Wendy S; Anderson, Lori S; Örlygsdóttir, Brynja
To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model. Little is known about how school nurses coordinate care for youth with asthma in different countries. A qualitative descriptive study design using focus group data. Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma. Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. © 2014 John Wiley & Sons Ltd.
Lentz, Judy C
Although the specialty of palliative nursing and palliative care continues to grow in hospital and outpatient settings, a paucity of home-based palliative services remains. This article discusses a new paradigm of faith-based palliative care ministry using faith community nurses (FCNs). Under the leadership of a palliative care doula (a nurse expert in palliative care), nurses in the faith community can offer critical support to those with serious illness. Models such as this provide stimulating content for FCN practice and opportunity to broaden health ministry within faith communities.
Huang, Hui-Man; Liao, Chi-Chun
Nurses are expected to discharge their duty of care effectively and professionally to prevent medical negligence. Only three articles have previously focused on medical negligence. Duty of care and medical negligence in nursing are topics that have been neglected in Taiwan. (1) Classify the duty of care of professional nurses; (2) Investigate the facts and disputes in the current case; (3) Clarify the legal issues involved with regard to duty-of-care violations in the current case; (4) Explore the causal relationships in a legal context between nurses' duty-of-care violations and patient harm / injury. Literature analysis and a case study are used to analyze Supreme Court Verdict No.5550 (2010). Duty of care for nursing professionals may be classified into seven broad categories. Each category has its distinct correlatives. In nursing practice, every nursing behavior has a corresponding duty. In this case, the case study nurse did not discharge her obstetric professional duty and failed to inform the doctor in a timely manner. Negligence resulted in prenatal death and the case study nurse was found guilty. In order to prevent committing a crime, nurses should gain a better understanding of their duty of care and adequately discharge these duties in daily practice.
Minton, Claire; Batten, Lesley
With consideration of an environmental concept, this paper explores evidence related to the negative impacts of the intensive care unit environment on patient outcomes and explores the potential counteracting benefits of 'nature-based' nursing interventions as a way to improve care outcomes. The impact of the environment in which a patient is nursed has long been recognised as one determinant in patient outcomes. Whilst the contemporary intensive care unit environment contains many features that support the provision of the intensive therapies the patient requires, it can also be detrimental, especially for long-stay patients. This narrative review considers theoretical and evidence-based literature that supports the adoption of nature-based nursing interventions in intensive care units. Research and theoretical literature from a diverse range of disciplines including nursing, medicine, psychology, architecture and environmental science were considered in relation to patient outcomes and intensive care nursing practice. There are many nature-based interventions that intensive care unit nurses can implement into their nursing practice to counteract environmental stressors. These interventions can also improve the environment for patients' families and nurses. Intensive care unit nurses must actively consider and manage the environment in which nursing occurs to facilitate the best patient outcomes. © 2015 John Wiley & Sons Ltd.
Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh
Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. This study aimed to audit nursing care based on a nursing process model. This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses' compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses' age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools.
Anzai, Eriko; Douglas, Clint; Bonner, Ann
The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.
Alharbi, Jalal; Wilson, Rhonda; Woods, Cindy; Usher, Kim
The aim of the study was to explore the prevalence of burnout and job satisfaction among Saudi national critical care nurses. Burnout is caused by a number of factors, including personal, organisational and professional issues. Previous literature reports a strong relationship between burnout and job satisfaction among critical care nurses. Little is known about this phenomenon among Saudi national critical care nurses. A convenience sample of 150 Saudi national critical care nurses from three hospitals in Hail, Saudi Arabia were included in a cross-sectional survey. Saudi national critical care registered nurses reported moderate to high levels of burnout in the areas of emotional exhaustion and depersonalisation. Participants also reported a feeling of ambivalence and dissatisfaction with their jobs but were satisfied with the nature of their work. Saudi national critical care nurses experience moderate to high levels of burnout and low levels of job satisfaction. Burnout is a predictor of job satisfaction for Saudi national critical care nurses. These results provide clear evidence of the need for nurse managers and policy makers to devise strategies to help nurses better cope with a stressful work environment, thereby also improving job satisfaction among Saudi national critical care nurses. © 2016 John Wiley & Sons Ltd.
Stuart, Megan; Melling, Sally
To explore and compare differences between parents' and nurses' perceptions of family-centred care (FCC) for children's acute short-stay admissions. Mixed-method questionnaires were designed to compare care task delegation between nurse and parent participants in the study. Parents and nurses had similar perceptions of task allocation in FCC. Parents generally were prepared to undertake basic care tasks only, rather than help with nursing interventions. Nurses had a comprehensive understanding of FCC. Most parents were not able to define FCC but carried it out naturally. In the UK, nurses and parents have similar expectations of FCC. It is unusual for parents to be given information or opportunities to engage in the care of the child beyond everyday tasks. The investigation highlighted the importance of negotiating with family members on each separate admission because, although most parents would be comfortable undertaking care tasks, each family and each situation is different.
Isaksen, Lise Widding
This article argues that international nurse recruitment from Latvia to Norway is not a win–win situation. The gains and losses of nurse migration are unevenly distributed between sender and receiver countries. On the basis of empirical research and interviews with Latvian nurses and families they left behind, this article argues that nurse migration transforms families and communities and that national health services now become global workplaces. Some decades ago feminist research pointed to the fact that the welfare state was based on a male breadwinner family and women’s unpaid production of care work at home. Today this production of unpaid care is “outsourced” from richer to poorer countries and is related to an emergence of transnational spaces of care. International nurse recruitment and global nurse care chains in Norway increasingly provide the labor that prevents the new adult worker model and gender equality politics from being disrupted in times where families are overloaded with elder care loads.
Inga E. Larsson
Full Text Available Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT was employed. Interviews were performed with patients (=17, recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.
AIMS AND OBJECTIVES: The aim of this phenomenological study was to explore the emotions experienced by children\\'s nurses when caring for children with burns, in addition to ascertaining how the nurses dealt with these emotions. BACKGROUND: The nature of nursing practice is such that it inevitably generates some form of emotional response in nurses. The literature reveals that the manner nurses deal with their emotional experiences can impact on their nursing care. DESIGN: The study used Husserlian phenomenology to explore the emotional experiences of eight purposively selected children\\'s nurses who have worked on the burns unit of an Irish paediatric hospital. METHODS: Data were collected using in-depth, unstructured interviews and analysed using Colaizzi\\'s seven stage framework. RESULTS: The phenomenon of participants\\' emotional experiences is captured in four themes: (1) caring for children with burns, (2) supporting parents, (3) sustaining nurses\\' emotional well-being, and (4) learning to be a burns nurse. Nursing children with burns generated a myriad of emotions for participants. Burns dressing-changes, managing burn-related pain, supporting parents and the impact of busy workloads on the emotional care of children and their parents emerged as the most emotionally challenging aspects of participants\\' role. Participants recognised the need to manage their emotional responses and spoke of the benefits of a supportive nursing team. CONCLUSIONS: The findings offer insights into both the rewarding and challenging aspects of nursing children with burns. Nurses in this environment must be supported to recognise and manage their emotional responses to their work. RELEVANCE TO CLINICAL PRACTICE: Helping nurses to manage the emotional consequences of their work will help to sustain their emotional well-being, enhance the care received by children and also enable nurses to support parents in their role as partners in care.
Hicks, Carolyn; Fide, Jane
Nurses working with breast cancer patients (n=119) identified general and cancer-specific continuing education needs; 13 of the 14 cancer-related needs ranked in the top 20. There were no differences between acute care and community nurses. Newly qualified nurses had significantly greater needs. (Contains 44 references.) (SK)
Adib-Hajbaghery, Mohsen; Zehtabchi, Samira; Fini, Ismail Azizi
The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. This study aimed to evaluate Iranian nurses' perceived professional competence in spiritual care, the relationship between perceived competence and nurses' personal characteristics, and barriers to provide spiritual care. A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses' competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses' overall score of competence in spiritual care and receiving training on spiritual care, nurses' position, and the ward they worked in. Confirming the findings of the international literature, this study puts light on the situation of nurses' perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care.
Full Text Available Background: Caring is the core of nursing and should be cultivated in student nurses. However, there are serious concerns about the caring concern in the clinical environment and in nursing education. Clinical instructors are ideally positioned to care for student nurses so that they in turn, can learn to care for their patients. Methods: A descriptive, comparative, cross-sectional and correlational quantitative research design with convenience sampling was conducted to describe the perceptions of junior student nurses (n = 148 and senior student nurses (n = 168 regarding clinicalin structor caring. A structured self administered questionnaire using the Nursing Student Perceptions of Instructor Caring (NSPIC (Wade & Kasper, 2006 was used. Descriptive statistics and hypotheses testing using parametric and non parametric methods were conducted. The reliability of the NSPIC was determined. Results: Respondents had a positive perception of their clinical instructors' caring. No relationship could be found between the course the respondents were registered for, the frequency of contact with a clinical instructor, the ages of the respondents and their perceptions of clinical instructor caring. The NSPIC was found to be reliable if one item each from two of the subscales were omitted. Conclusions: Student nurses perceived most strongly that a caring clinical instructor made them feel confident, specifically when he/she showed genuine interest in the patients and their care, and when he/she made them feel that they could be successful.
Montayre, Jed; Montayre, Jasmine
Evidence suggests that delivery of good nursing care in long-term care (LTC) facilities is reflected in nurses' descriptions of the factors and structures that affect their work. Understanding the contemporary nature of nursing work in aged care will influence policies for improving current work structures in this practice setting. The current review aims to present a contemporary perspective of RNs' work in LTC facilities. A comprehensive search and purposeful selection of the literature was conducted using CINAHL, PubMed, Medline, Scopus, and Google Scholar databases. Nine studies were eligible for review. Common themes revealed that nursing work in aged care settings is characterized by RNs providing indirect care tasks-primarily care coordination, engaging in non-nursing activities, and having an expanded and overlapping role. As care providers, aged care RNs do not always provide direct care as part of their nursing work. The scope of RN work beyond its clinical nature or performance of non-nursing tasks adds complexity in clarifying RN work roles in aged care. [Journal of Gerontological Nursing, 43(11), 41-49.]. Copyright 2017, SLACK Incorporated.
Gielen, Joris; van den Branden, Stef; van Iersel, Trudie; Broeckaert, Bert
To adequately measure the attitudes of Flemish palliative care nurses toward euthanasia, and assess the relationship between these attitudes and demographic factors and the (perceived) influence of experience in palliative care on death anxiety. An anonymous questionnaire was sent to all nurses (n=589) employed in palliative care in Flanders, Belgium: 70.5% of the nurses (n=415) responded. A majority of the nurses supported the Belgian law regulating euthanasia but also believed that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care. Three clusters were discovered: staunch advocates of euthanasia (150 nurses, 41.1%); moderate advocates of euthanasia (135 nurses, 37%); and (moderate) opponents of euthanasia (80 nurses, 21.9%). An absolute opposition between advocates and opponents of euthanasia was not observed. A statistically significant relationship was found between the euthanasia clusters and years of experience in palliative care, and (perceived) influence of experience in palliative care on anxiety when a patient dies. Flemish palliative care nurses' attitudes toward euthanasia are nuanced and contextual. By indicating that most euthanasia requests disappear as soon as a patient experiences the benefits of good palliative care, the nurses applied a 'palliative filter' a standard procedure in the case of a euthanasia request.
Macabasag, Romeo Luis A; Diño, Michael Joseph S
Caring is considered a unique concept in nursing because it subsumes all intrinsic attributes of nursing as a human helping discipline. Scholars have argued that caring is usually seen as an encounter between nurses and patients, but how about nurses with minimal or absent nurse-patient encounters, like informatics nurses? In this study, we explored the meaning of the phenomenon of caring to present lived experiences of caring, namely caring as actions of coming in between; caring as expressed within embodied relations; and caring and the path traversed by informatics nurses. The informatics nurse-cyborg-patient triad speaks of Filipino informatics nurses' insightful understanding of the phenomenon of caring.
Papua New Guinean nurses work in a sociomedical system in which cultural and linguistic diversity are matters of pressing concern. Using data drawn from ethnographic research with PNG nursing students, I show how nursing education socializes nurses to take stances toward language and communication that impact their care practices. I argue that nurses' use of language is shaped by their ethical commitments as educated Christians and indigenous concerns about the links between language, emotion, and health. In a resource-poor setting where health workers risk blame for structural inequalities, this "ethical metapragmatics" is an important but neglected facet of care work.
Sprakes, Kate; Tyrer, Julie
Wound and pressure ulcer prevention are key quality indicators of nursing care. This article describes a collaborative project between a community skin care service and a nursing home. The aim of the project was to establish whether the implementation of a wound and pressure ulcer management competency framework within a nursing home would improve patient outcomes and reduce the severity and number of wounds and pressure ulcers. Following the project's implementation, there was a reduction in the number of wounds and pressure ulcers, hospital admissions and district nursing visits. Nursing home staff also reported an increase in their knowledge and skills.
Raymond, Anita; Lee, Susan F; Bloomer, Melissa J
To investigate nurses' roles and responsibilities in providing bereavement care during the care of dying patients within acute care hospitals. Bereavement within acute care hospitals is often sudden, unexpected and managed by nurses who may have limited access to experts. Nurses' roles and experience in the provision of bereavement care can have a significant influence on the subsequent bereavement process for families. Identifying the roles and responsibilities, nurses have in bereavement care will enhance bereavement supports within acute care environments. Mixed-methods systematic review. The review was conducted using the databases Cumulative Index Nursing and Allied Health Literature Plus, Embase, Ovid MEDLINE, PsychINFO, CareSearch and Google Scholar. Included studies published between 2006-2015, identified nurse participants, and the studies were conducted in acute care hospitals. Seven studies met the inclusion criteria, and the research results were extracted and subjected to thematic synthesis. Nurses' role in bereavement care included patient-centred care, family-centred care, advocacy and professional development. Concerns about bereavement roles included competing clinical workload demands, limitations of physical environments in acute care hospitals and the need for further education in bereavement care. Further research is needed to enable more detailed clarification of the roles nurse undertake in bereavement care in acute care hospitals. There is also a need to evaluate the effectiveness of these nursing roles and how these provisions impact on the bereavement process of patients and families. The care provided by acute care nurses to patients and families during end-of-life care is crucial to bereavement. The bereavement roles nurses undertake are not well understood with limited evidence of how these roles are measured. Further education in bereavement care is needed for acute care nurses. © 2016 John Wiley & Sons Ltd.
Schroyer, Coreena C; Zellers, Rebecca; Abraham, Sam
Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.
Bender, Miriam; Spiva, LeeAnna; Su, Wei; Hites, Lisle
To determine the power of a conceptual clinical nurse leader practice model to explain the care model's enactment and trajectory in real world settings. How nursing, organised into specific models of care, functions as an organisational strategy for quality is not well specified. Clinical nurse leader integrated care delivery is one emerging model with growing adoption. A recently validated clinical nurse leader practice model conceptualizes the care model's characteristics and hypothesizes their mechanisms of action. Pattern matching case study design and mixed methods were used to determine how the care model's constructs were operationalized in one regional United States health system that integrated clinical nurse leaders into their care delivery system in 2010. The findings confirmed the empirical presence of all clinical nurse leader practice model constructs and provided a rich description of how the health system operationalized the constructs in practice. The findings support the hypothesized model pathway from Clinical Nurse Leader structuring to Clinical Nurse Leader practice and outcomes. The findings indicate analytic generalizability of the clinical nurse leader practice model. Nursing practice organised to focus on microsystem care processes can catalyse multidisciplinary engagement with, and consistent enactment of, quality practices. The model has great potential for transferability across diverse health systems. © 2018 John Wiley & Sons Ltd.
Moskalenko, V F; Gorban', E N; Tabachnikov, S I; Syropiatov, O G; Shtengelov, V V
An analysis was performed of the conception and content of a new Psychiatric Care Act by making a comparison with data from published literature and the present-day status of the mental health protection service. The main features of the crisis of psychiatry in Ukraine are characterized together with possible ways of resolving it. Main trends in reformation of the psychiatric service are identified that are to be secured by relevant acts of departmental and interdepartmental character based on law. Priority is emphasized to defence of the patients' rights and liberties together with a need for a guarantee of a highly skilled medical care to be provided for mental patients.
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Florida State Univ., Tallahassee. Center for Instructional Development and Services.
This document demonstrates the relationships among four Florida nursing education programs (home health aide, nursing assistant, patient care assistant, and practical nursing) by listing student performance standards and indicating which ones are required in each program. The 268 student performance standards are arranged in 23 areas of…
Karanikola, Maria N K; Albarran, John W; Drigo, Elio; Giannakopoulou, Margarita; Kalafati, Maria; Mpouzika, Meropi; Tsiaousis, George Z; Papathanassoglou, Elizabeth D E
To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P intention to resign (r = 0.244, P intention of nurses to resign (r = -0. 209, P intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress. Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession. © 2013 John Wiley & Sons Ltd.
Jarrin, Olga F.
Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry. PMID:22222236
Jarrin, Olga F.
Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry.
Johnson, K A; Valdez, R S; Casper, G R; Kossman, S P; Carayon, P; Or, C K L; Burke, L J; Brennan, P F
The infusion of health care technologies into the home leads to substantial changes in the nature of work for home care nurses and their patients. Nurses and nursing practice must change to capitalize on these innovations. As part of a randomized field experiment evaluating web-based support for home care of patients with chronic heart disease, we engaged nine nurses in a dialogue about their experience integrating this modification of care delivery into their practice. They shared their perceptions of the work they needed to do and their perceptions and expectations for patients and themselves in using technologies to promote and manage self-care. We document three overarching themes that identify preexisting factors that influenced integration or represent the consequences of technology integration into home care: doing tasks differently, making accommodations in the home for devices and computers, and being mindful of existing expectations and skills of both nurses and patients.
Lowe, Janet; Cagginello, Joan; Compton, Linda
Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and